Glucocorticoid trajectories in preterm infants—born too soon, wired differently
Authors' conclusion
Despite a high production rate of GC precursors in preterm infants, the total GC production remained relatively constant and was regulated at the level of CYP11B1. Persisting differences between preterm and full-term infants in GC precursor levels as well as in GC production were observed, indicating possible programming effects of preterm birth.
Study context
- Population
- Preterm infants born <30 weeks of gestational age (8 boys), followed from the NICU through the first year of life154 urinary samples
- Participants
- 16 infants
- Exposure
- Preterm vs full-term infants
- Pretermn = 16
- Outcome
- Urinary levels of GC precursor metabolites and 13 GC metabolites; enzyme activities by product/substrate ratios
- Follow-up
- First year of life
Methodological detailsspot urinary samples, gas chromatography-mass spectrometry, mixed models
- Spot urinary samples
- Gas chromatography-mass spectrometry
- Mixed models
Main finding
As reported in the abstract
Maturation of the GC metabolic pathway (urinary GC precursor and GC metabolites)
- Glucocorticoid (GC) precursor levels remained high in preterm infants until term-equivalent age (TEA), then decreased
- P < .001
- GC production higher in preterm than full-term infants after 1 week of age
- P = .044 -<.001
- Sum of 13 GC metabolites/tetrahydro-11-deoxycortisol ratio (CYP11B1 activity) increased in preterm infants after TEA
- P < .001
- 16α-OH-DHEA/5-PT ratio (lyase activity) decreased in preterm infants after TEA
- P < .001
- Cortisone/cortisol metabolite ratio higher in preterm infants before TEA than thereafter
- P < .001
Observational data: associations, not effects.
Original publication
Glucocorticoid trajectories in preterm infants—born too soon, wired differently. J Clin Endocrinol Metab. Published 14 February 2026. doi:10.
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