Association of Serum Cortisol Levels with Respiratory Distress Syndrome and Mortality in Premature Babies

Esculapio Pub Date : 2023-05-13 DOI:10.51273/esc23.251919

Dr Muhammad Sajid, Nousheen Fatima, Mir Nousharwan, Ameer Ahmad

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Abstract

Objective: To evaluate Trends of cortisol level and its relation with Respiratory distress syndrome and Mortality in premature babies Materials & Methods: A descriptive cross sectional study was conducted in Neonatal unit of pediatric medicine 1 of Bahawalvictoria hospital Bahawalpur from Feb 2021 to June 2021.Premature babies (less than 36 weeks gestation by ballard scoring )admitted in Preterm ward on day 1 were enrolled after informed consent and ruling out exclusion criteria (More than 24 hour old , Who have received antenatal steroids for lung maturation, Received any treatment before admission in any other hospital, Patient having Any obvious anomaly ).Day 1 sample sent for CRP and cortisol. Data recorded regarding weight, gestational age (ballard scoring), septic risk factors. These patients were followed for development of RDS ( on X ray at 24 hour of life). Outcome was documented as expiry, discharged or LAMA. Data analyzed in SPSS 20. Results:40 patients were enrolled as per inclusion criteria. 27 (67.5 % ) were male and 13 (32.5 %) were female. Gestational age 3 (7.5 %) had less than 28 weeks, 29-30 weeks were 6 (15 %), 31-34 weeks were 31 (77.5 %). Weight less than 1.5 kg were 23 (57.5%), 1.5 to2 kg were 15 (37.5 %), 2.1-2.5 kg were 2 (5%). Cortisol level low in 4 (10 %), normal in 6 (15 %), high in 30 (75 %).22 (55 %) discharged, 13 (32 %) expired, and 5 (12.5 %) got LAMA. Cortisol level as compared to outcome has p value 0.002. Tweleve (30 %) had RDS. Twenty two (55 %) had evidence of sepsis. 18 (45 %) had CRP more than 6. Cortisol level as compared to RDS presence has P value 0.057 and with sepsis has P value 0.007. Mean cortisol in discharged patients were 19.8, expired 14.2 and LAMA has 22.7. Mean cortisol in RDS patients were 18.3 and RDS absent had 18.3 also. Mean cortisol in Sepsis positive patients were 18.6 and sepsis absent were 18.0 Conclusion: Mean cortisol has no significant difference in discharged and expired patients.

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血清皮质醇水平与早产儿呼吸窘迫综合征和死亡率的关系

目的:探讨早产儿皮质醇水平变化趋势及其与呼吸窘迫综合征和死亡率的关系方法:采用描述性横断面研究方法，于2021年2月至2021年6月在巴哈瓦尔布尔Bahawalvictoria医院儿科医学1新生儿科进行。在知情同意并排除排除标准后，于第1天入住早产儿病房的早产儿(巴拉德评分小于36周)(出生24小时以上，曾接受过产前肺成熟类固醇治疗，入院前在其他医院接受过任何治疗，患者有任何明显异常)。第一天送样品检测CRP和皮质醇。记录有关体重、胎龄(ballard评分)、脓毒性危险因素的数据。随访这些患者的RDS发展情况(出生后24小时X光片)。结果记录为到期、出院或LAMA。数据分析采用SPSS 20。结果:40例患者按纳入标准入组。男性27例(67.5%)，女性13例(32.5%)。胎龄3小于28周者占7.5%，29 ~ 30周者占6(15%)，31 ~ 34周者占31(77.5%)。体重1.5 kg以下的23例(57.5%)，1.5 ~ 2 kg的15例(37.5%)，2.1 ~ 2.5 kg的2例(5%)。22 .皮质醇水平低4例(10%)，正常6例(15%)，高30例(75%)出院者占55%，过期者13例(32%)，获得LAMA者5例(12.5%)。皮质醇水平与结果相比p值为0.002。12例(30%)有RDS。22例(55%)有败血症的证据。18例(45%)CRP≥6。皮质醇水平与RDS相比P值为0.057，与脓毒症相比P值为0.007。出院患者平均皮质醇19.8，过期患者平均皮质醇14.2,LAMA平均皮质醇22.7。RDS患者的平均皮质醇为18.3，无RDS患者的平均皮质醇为18.3。脓毒症阳性患者的皮质醇均值为18.6，无脓毒症患者的皮质醇均值为18.0。结论:出院患者和过期患者的皮质醇均值无显著差异。

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Esculapio

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审稿时长

12 weeks