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| 2. |
- Ivars, Katrin, et al.
(författare)
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Development of Salivary Cortisol Circadian Rhythm and Reference Intervals in Full-Term Infants
- 2015
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Ingår i: Plos One. - San Francisco, USA : Public Library of Science (PLoS). - 1932-6203. ; 10:6
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Tidskriftsartikel (refereegranskat)abstract
- Background Cortisol concentrations in plasma display a circadian rhythm in adults and children older than one year. Earlier studies report divergent results regarding when cortisol circadian rhythm is established. The present study aims to investigate at what age infants develop a circadian rhythm, as well as the possible influences of behavioral regularity and daily life trauma on when the rhythm is established. Furthermore, we determine age-related reference intervals for cortisol concentrations in saliva during the first year of life. 130 healthy full-term infants were included in a prospective, longitudinal study with saliva sampling on two consecutive days, in the morning (07:30-09:30), noon (10:00-12:00) and evening (19:30-21:30), each month from birth until the infant was twelve months old. Information about development of behavioral regularity and potential exposure to trauma was obtained from the parents through the Baby Behavior Questionnaire and the Life Incidence of Traumatic Events checklist. A significant group-level circadian rhythm of salivary cortisol secretion was established at one month, and remained throughout the first year of life, although there was considerable individual variability. No correlation was found between development of cortisol circadian rhythm and the results from either the Baby Behavior Questionnaire or the Life Incidence of Traumatic Events checklist. The study presents salivary cortisol reference intervals for infants during the first twelve months of life. Cortisol circadian rhythm in infants is already established by one month of age, earlier than previous studies have shown. The current study also provides first year age-related reference intervals for salivary cortisol levels in healthy, full-term infants.
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| 3. |
- Ivars, Katrin, 1978-, et al.
(författare)
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Development of salivary cortisol circadian rhythm in preterm infants
- 2017
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 12:8
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate at what age preterm infants develop a salivary cortisol circadian rhythm and identify whether it is dependent on gestational age and/or postnatal age. To evaluate whether salivary cortisol circadian rhythm development is related to behavioral regularity. To elucidate salivary cortisol levels in preterm infants during the first year of life.Methods: This prospective, longitudinal study included 51 preterm infants. 130 healthy full-term infants served as controls. Monthly salivary cortisol levels were obtained in the morning (07:30-09:30), at noon (10:00-12:00), and in the evening (19:30-21:30), beginning at gestational age week 28-32 and continuing until twelve months corrected age. Behavioral regularity was studied using the Baby Behavior Questionnaire.Results: A salivary cortisol circadian rhythm was established by one month corrected age and persisted throughout the first year. The preterm infants showed a cortisol pattern increasingly more alike the full-term infants as the first year progressed. The preterm infants increase in behavioral regularity with age but no correlation was found between the development of salivary cortisol circadian rhythm and the development of behavior regularity. The time to establish salivary cortisol circadian rhythm differed between preterm and full-term infants according to postnatal age (p = 0.001) and was dependent on gestational age. Monthly salivary cortisol levels for preterm infants from birth until twelve months are presented. Additional findings were that topical corticosteroid medication was associated with higher concentrations of salivary cortisol (p = 0.02) and establishment of salivary cortisol circadian rhythm occurred later in infants treated with topical corticosteroid medication (p = 0.02).Conclusions: Salivary cortisol circadian rhythm is established by one month corrected age in preterm infants. Establishment of salivary cortisol circadian rhythm is related to gestational age rather than to postnatal age. Salivary cortisol circadian rhythm development is not related to behavioral regularity.
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- Leijon, Ingemar, 1942-, et al.
(författare)
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God prognos för unga vuxna med mycket låg födelsevikt [Follow-up study of very low birthweight children in Sweden at the age of 27-28]
- 2020
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Ingår i: Läkartidningen. - Stockholm, Sweden : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 117
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Tidskriftsartikel (refereegranskat)abstract
- Studies show that very low birthweight can be an important risk factor for mental problems, disturbed fertility and neuroendocrine dysregulation. In a regional long-term study 56 of 86 adult individuals 27 to 28 years of age with a very low birthweight were compared with normal birthweight controls. Analyses of self-reported mental health, socio-demographic factors, sex hormone levels, and hair cortisol levels showed no significant differences between the groups. However, in order to analyse subgroups with different risk factors from the newborn period or children with a variety of social background factors, larger patient groups are needed.
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| 5. |
- Leijon, Ingemar, 1942-, et al.
(författare)
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Self-reported mental health and cortisol activity at 27-28 years of age in individuals born with very low birthweight
- 2020
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 109:5, s. 948-958
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Tidskriftsartikel (refereegranskat)abstract
- AimTo assess mental health outcomes of very low birthweight (VLBW, <1500 g) subjects to adulthood and to examine salivary cortisol and hair cortisol levels and their relation to birth characteristics and mental health.MethodsA Swedish regional cohort of 56 VLBW subjects and 55 full‐term controls were assessed at the ages 27‐28 with adult self‐reported scales and the mean of 2 days diurnal salivary cortisol and hair cortisol. The cohorts had been assessed at 15 years of age with youth self‐reported scales.ResultsThere were no differences between the groups in youth self‐reported scales and adult self‐reported scores. The 24 participating VLBW girls scored lower on youth self‐reported scales externalising and total problem scores than the control girls. In adulthood, the 21 participating VLBW women had significantly higher morning concentrations of salivary cortisol than control women, P = .014. No significant associations were found between cortisol concentrations and adult self‐reported scales internalising, externalising and total scores.ConclusionSelf‐reported mental health in VLBW subjects was comparable with normal birthweight controls indicating a satisfying transition from adolescence to adulthood. VLBW females had higher morning salivary cortisol concentrations, suggesting a gender difference. We found no correlations between cortisol and mental health.
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| 6. |
- Morelius, Evalotte, et al.
(författare)
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Stress at three-month immunization : Parents and infants salivary cortisol response in relation to the use of pacifier and oral glucose
- 2009
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 13:2, s. 202-208
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to investigate (1) whether the salivary cortisol response could be dampened during a routine three-month immunization if the infant received sweet-tasting solution in combination with a pacifier and (2) stress experienced by parents during immunization of the infant. Ninety-eight infants were included into one of four intervention groups: glucose and pacifier, water and pacifier, glucose, or water. Saliva was collected before and 30 min after the immunization. Infants crying-time and parents self-reported stress (VAS) were measured before and after immunization, Infants in the pacifier and glucose group had a significantly smaller change in salivary cortisol than infants in the other groups (F-3.72 = 3.1, p < 0.05). In the glucose and pacifier group the median salivary cortisol levels decreased 33% after the immunization. In the water and pacifier, glucose, and water group median cortisol increased with 50%, 42%, and 8%, respectively. No significant differences in crying-time were observed between the intervention groups. If the infant cried before the immunization, the crying-time during the immunization was longer (p < 0.01) and cortisol increased more (p < 0.05). Median cortisol levels for parents decreased after the immunization (p < 0.01). Median VAS increased 50% (p < 0.0001) after immunization. First time parents rated higher stress on VAS before immunization (p < 0.01). Parents change in cortisol and VAS were significantly related to infants crying time. In conclusion, the combination of oral glucose and pacifier dampen infants salivary cortisol in response to the three-month immunization.
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| 7. |
- Mörelius, Eva-Lotta, et al.
(författare)
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Salivary cortisol and administration of concentrated oral glucose in newborn infants: improved detection limit and smaller sample volumes without glucose interference
- 2004
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Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 64:2, s. 113-118
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Tidskriftsartikel (refereegranskat)abstract
- Newborn infants are subject to repetitive painful and stressful events during neonatal intensive care. When the baby attempts to cope with a stressful situation the hypothalamus-pituitary-adrenal axis is activated, releasing cortisol. The free cortisol response is optimally measured in saliva and saliva samples can be taken easily and without pain. However, saliva is very scarce in infants and saliva stimulants can interfere with analytical methods. Nowadays, sweet solutions are frequently administered to neonates prior to a disturbing procedure in order to reduce pain. The possible interference of sweet solutions with the measurement of salivary cortisol has not yet been documented. The aims of the present study were to further improve the detection limit of the radioimmunoassay used for cortisol analysis and to determine the degree of interference of high concentrations of glucose with the analytical method. By decreasing incubation temperature and prolonging the incubation time it was possible to improve the detection limit of the radio immunoassay (RIA) to 0.5 nmol/L at the same time as the sample volume was decreased to 10 μL saliva. Saliva was collected from full-term and preterm babies and was sufficient for analysis in 113 out of 116 (97%) samples. Glucose in the concentrations and amounts commonly used for pain relief did not interfere with the RIA method. In conclusion, it is feasible to collect microlitre volumes of saliva and analyse even very low concentrations of cortisol in newborns. It is also possible to offer the baby oral glucose prior to a painful procedure and still reliably measure salivary cortisol.
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| 8. |
- Mörelius, Evalotte, et al.
(författare)
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Saliva collection using cotton buds with wooden sticks: a note of caution
- 2006
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Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 66:1, s. 15-18
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to investigate whether the cotton-tipped applicators (cotton buds) used to collect saliva in infants can be stored un-centrifuged prior to cortisol analysis, and to test whether there is any difference in results between wooden and plastic-shafted sticks. Saliva was collected from 10 healthy adults using 6 cotton buds, i.e. 3 with wooden sticks and 3 with plastic sticks. The samples were then centrifuged at three different time-points: immediately after collection, after 24 h and after 48 h. Using cotton buds with wooden sticks, median salivary cortisol was significantly lower after 24 h (40 %) (p<0.001) and after 48 h (49 %) (p<0.001) of storage than it was of the samples centrifuged immediately. There was no significant difference between the samples centrifuged immediately and those centrifuged after 24 h and 48 h when saliva was collected using the cotton buds with plastic sticks. It is concluded that cotton buds with wooden sticks should not be used in studies of salivary cortisol unless it is possible to centrifuge the saliva immediately. Moreover, it is inadvisable to alternate between cotton buds with wooden and plastic sticks in the same study when collecting saliva for analysis of cortisol.
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| 9. |
- Mörelius, Evalotte, et al.
(författare)
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Salivary cortisol and mood and pain profiles during skin-to-skin care for an unselected group of mothers and infants in neonatal intensive care
- 2005
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 116:5, s. 1105-1113
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Mother-infant separation after birth is a well-known source of stress. Parents and preterm infants in neonatal intensive care are separated immediately after birth. Skin-to-skin care is 1 possible method to reduce the separation-dependent stress. The aim of the present study was to investigate how skin-to-skin care influences stress for the mother and the infant in neonatal intensive care. Methods. Seventeen mother-infant pairs were included at their first and fourth skin-to-skin care. The infants were 25 to 33 weeks' gestational age, with birth weights ranging from 495 to 2590 g. In mothers, salivary cortisol, heart rate, mood scale, and stress measured on a visual analog scale (VAS) were analyzed. In infants, salivary cortisol and heart rate were analyzed, and because pain is one facet of stress, 2 different pain scales were used. Results. In mothers, the skin-to-skin care decreased salivary cortisol (32%), heart rate (7%), and VAS (89%), whereas mood increased (6%). Before the fourth skin-to-skin care, mothers rated less stress on VAS, and salivary cortisol and heart rate improved faster. The infants' cortisol either increased or decreased. Their heart rates and pain scores decreased during skin-to-skin care. Conclusions. Our results lend additional support to the value of skin-to-skin care in neonatal intensive care. Variable stress responses in preterm infants favor the need for individualized care. The mothers' need for support seem to be more pronounced in the first skin-to-skin session as our results show a higher degree of stress as compared with later skin-to-skin care.
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