Longitudinal Study of Plasma Dehydroepiandrosterone Sulfate in Preterm and Fullterm Infants

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Abstract
To determine factors that influence the involution of the fetal adrenal gland in newborn infants, we measured plasma concentrations of dehydroepiandrosterone sulfate (DS), a major secretory product of the fetal zone of the adrenal gland. Serial DS measurements, by RIA, were conducted in 23 normally grown fullterm and 28 premature infants as well as in 13 newborns with intrauterine growth retardation (IUGR). None of the infants was severely ill. After vaginal delivery in 44 newborns, including 7 with IUGR, DS concentrations were higher than in adults (3.25 μg/ml). Values in premature and fullterm infants and infants with and without IUGR were not statistically different during the first 3 days of life. The decrease in plasma DS levels in these infants was closely correlated to the peak DS level on day 1 (r = −0.996; n = 20), but was not dependent on gestational age (GA). DS concentrations on days 1–3 were much lower in premature and fullterm infants delivered by cesarean section than in vaginally delivered infants and did not change significantly during the first 3 days of life. After day 6 of life, the logarithms (In) of the plasma DS concentrations (y) were negatively correlated to postconceptional age (PCA = GA — 2 weeks + postnatal age in weeks = x): y = 35.26·e−0.115·x (r = −0.583; n = 205; P < 0.001). Mean plasma DS concentrations at 28 and 40 weeks PCA were 1.42 and 0.36 μg/ml, respectively. Infants with IUGR had DS concentrations similar to those of normally grown newborns. The results indicate that vaginal delivery is a potent stimulus for DS production during the first days of life, independent of GA. After the sixth day of life, PCA seemed to be an important determinant of DS concentrations in our healthy newborns, while IUGR had little influence. Whether the relationship between age and DS concentrations implies a programmed maturation of the adrenal cortex remains to be clarified. Alternatively, extrauterine life may be stressful and lead to an increase in ACTH and other pituitary factors that stimulate DS production in premature infants.

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