Salivary cortisol is not associated with dexamethasone response in preterm infants with evolving bronchopulmonary dysplasia

Tamorah Lewis; Erik A Jensen; Sherry Courtney; Jonathan Slaughter; Matthew J Kielt; Narayan Prahbu Iyer; Cheri Gauldin; Christopher Nitkin; Hung-Wen Yeh; William Truog

doi:10.1038/s41372-024-02177-x

Salivary cortisol is not associated with dexamethasone response in preterm infants with evolving bronchopulmonary dysplasia

J Perinatol. 2024 Nov 21. doi: 10.1038/s41372-024-02177-x. Online ahead of print.

Authors

Tamorah Lewis^{1

2}, Erik A Jensen³, Sherry Courtney⁴, Jonathan Slaughter⁵, Matthew J Kielt⁵, Narayan Prahbu Iyer⁶, Cheri Gauldin⁷, Christopher Nitkin⁷, Hung-Wen Yeh⁸, William Truog⁷

Affiliations

¹ Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON, Canada. Tamorah.lewis@sickkids.ca.
² Department of Paediatrics, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada. Tamorah.lewis@sickkids.ca.
³ Department of Pediatrics, Division of Neonatology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA.
⁴ Division of Neonatology, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Research Institute, Fayetteville, NC, USA.
⁵ Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, OH, USA.
⁶ Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁷ Center for Infant Pulmonary Disorders, Children's Mercy Hospital; and University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
⁸ Division of Health Services and Outcomes Research, Children's Mercy Hospital; and University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.

PMID: 39567652
DOI: 10.1038/s41372-024-02177-x

Abstract

Objective: Short-term treatment efficacy of systemic dexamethasone (DEX) in preterm infants with bronchopulmonary dysplasia (BPD) is highly variable. Our objective was to assess if salivary cortisol may serve as a reliable biomarker of steroid response.

Study design: Multi-site prospective observational cohort study. Salivary cortisol was measured before and after DEX treatment. Respiratory Severity Score (RSS) quantified clinical response.

Results: Fifty-four infants with median (inter-quartile range) gestational age of 25.1 (24.1,26.5) weeks initiated DEX at 30 (23,48) days' postnatal age. Median baseline and post-treatment cortisol levels were 0.3 (0.2,0.6) μg/dl; 8.3 (5.5,16.5) nmol/L and 0.2 (0.1,0.3) μg/dl; 5.5 (2.8,8.3) nmol/L, respectively. RSS values decreased by a median of 3.1(1.6,5.0) Change in RSS did not correlate with baseline cortisol or change in cortisol levels.

Conclusion: In this first study to assess salivary cortisol as a biomarker for DEX response in BPD, salivary cortisol did not predict dexamethasone response.

Abstract

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