Development of 24-Hour Rhythms in Cortisol Secretion Across Infancy: A Systematic Review and Meta-Analysis of Individual Participant Data
Authors' conclusion
The early-morning peak in cortisol secretion gradually emerges from birth onwards to form a stable morning/evening ratio from age 6 to 9 months. This might have implications for hydrocortisone replacement therapy in infants with an inborn form of adrenal insufficiency.
Study context
- Population
- Healthy infants aged 0–1 year; studies reporting spontaneous (not stress-induced) salivary cortisol concentrations
- Participants
- 1,904 infants15 study cohorts
- Comparison
- Birth vs 6 to 9 months
- Outcome
- Daily variation in salivary cortisol concentration (morning/evening cortisol ratio) across the first year of life
Methodological detailsone-stage approach, linear mixed-effects modeling
- One-stage approach
- Linear mixed-effects modeling
Pooled result
As reported in the abstract
Morning/evening cortisol ratio
Birth
1.7
95% CI 1.3–2.1
6 to 9 months
3.7
95% CI 3.0–4.5
P < 0.0001
Further pooled results
24-hour rhythm (cosinor analysis)
- Gradual emergence of a 24-hour rhythm during infancy
Systematic review yield
- Eligible publications
- 54
- Cortisol observations reported
- 29 177
- Cortisol measurements in IPD
- 17 079
Original publication
Development of 24-Hour Rhythms in Cortisol Secretion Across Infancy: A Systematic Review and Meta-Analysis of Individual Participant Data. J Clin Endocrinol Metab. Published 29 August 2024. doi:10.
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