부산대학교 도서관

The function of the definitive and fetal zones of the adrenal cortex were studied in 8 pre-term(PT) neonates with adequate weight for gestational age (AGA) and in 10 small for gestational age (SGA) PTs during the first 14 days of post-natal life, as well as in 9 full-term (FT)AGA newborns during the first 7 days of postnatal life. Peripheral vein serum Cortisol and 17a-hydroxyprogesterone (17-OH-P) were used as parameters of the function of the definitive zone, while serum dehydroepiandrosterone sulphate (DS) was taken as indicator of the function of the fetal zone of the adrenal cortex. Cord vein blood (CVB) serum 17-OH-P was used as a marker of the function of the fetoplacental unit. There was a significant negative correlation between 1-day-old and 5-day-old serum 17-OH-P, Cortisol or DS and gestational age in the 27 subjects studied. On the other hand, there was a significative negative correlation between serum 17-OH-P and days of postnatal life in the 3 groups of neonates, and between serum Cortisol and days of postnatal life in PT AGA neonates but not in PT SGA newborns. During the first week of life, mean ± SD serum Cortisol was 267±143 and 273±136 mol/l in PT AGA and PT SGA neonates respectively, significantly higher (p<0.05 and p<0.02) than in FT newborns (118±81), while serum 17-OH-P was higher (p <0.05) in PT AGA neonates only (8,77±6.6 vs 3.60 ±2.81 nmol/l in FT). Serum 17-OH-P was lower in cord vein blood of PT, as well as in mother's blood during delivery, compared to that of FT (67±86 vs 341±182 nmol/l, p<0.01). Our data showing higher levels of Cortisol and 17-OH-P in PT newborns suggests that the stress of the extra uterine adaptation in prematurity resutls in an adequate response of the definitive zone of the adrenal cortex. On the other hand, higher serum 17-OH-P levels present in PT neonates should be taken into account for the differential diagnosis of 21-hydroxylase deficiency.