The utility of a random cortisol level in determining neonatal central adrenal insufficiency
Authors' conclusion
This study demonstrates that though an rSC can be used within the first 4 months of life, its value is best when done ≤30 days of life. Moreover, a diagnostic cut-off for CAI using rSC levels was identified for term infants.
Study context
- Population
- Infants who underwent a low dose cosyntropin stimulation test ≤4 months of life with random serum cortisol (rSC) as baseline cortisol; mean age 50.5 ± 38.08 days, 37% born at term
- Participants
- 251 infants
- Exposure
- Random serum cortisol in central adrenal insufficiency (CAI) vs at risk for CAI (ARF-CAI) vs non-CAI infants
- Outcome
- Utility of rSC in the evaluation of CAI: mean rSC by group and ROC-derived rSC cut-off for CAI
Methodological detailsretrospective chart review
- Retrospective chart review
Main finding
As reported in the abstract
Random serum cortisol
CAI vs ARF-CAI: P = 0.002 · CAI vs non-CAI: P = 0.007
Observational data: associations, not effects.
Further findings
ROC-derived rSC cut-off for diagnosis of CAI in term infants
- rSC cut-off
- 5.6 mcg/dL
- Sensitivity
- 42.6%
- Specificity
- 100%
- Term infants
Original publication
The utility of a random cortisol level in determining neonatal central adrenal insufficiency. Clin Endocrinol (Oxf). Published 20 March 2023. doi:10.
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