UMBILICAL CORD CORTISOL LEVELS IN TERM AND LATE-PRETERM NEWBORNS
Journal
Journal of Morphological Sciences
Date Issued
2025
Author(s)
Martinovska, Iskra
Laban Gucheva, Nevenka
Baevska Vuchkovikj, Tatjana
DOI
616.38:577.175.534
Abstract
Cortisol, a glucocorticoid hormone secreted by the adrenal cortex, plays a pivotal role in human
physiology, particularly in stress response regulation, immune function, and metabolic homeostasis. In
the perinatal period, cortisol becomes a critical determinant of neonatal outcomes, as it drives the
maturation of key fetal organs and facilitates the transition from intrauterine to extra uterine life. A
surge in fetal cortisol levels during late gestation is integral to the development of the lungs, liver, and
brain, which are essential for postnatal survival. Moreover, the umbilical cord, as the primary channel
of maternal-fetal exchange, provides an invaluable window into the hormonal state of the fetus at birth.
An observational prospective study analyzing umbilical cord blood cortisol levels, focusing on
their associations with gestational age, was conducted at the Mother Teresa Hospital in Skopje, and 88
samples were obtained for analysis.
The aim was to compare cortisol levels in healthy and appropriate for gestational age (AGA)
newborns, depending on their gestational age.
The results showed a mean cortisol level of 93.41 [95%CI 82.72 – 104.10]. In term infants the
mean cortisol level was significantly higher, with a mean value of 100.60 [95%CI 88.940 – 112.259],
than in preterm ones where mean cortisol level was 51.91 [95%CI 40.528 – 63.301], with a statistically
significant difference (p<0.0012).
The significant associations between cortisol levels and gestational age highlight the potential
utility of umbilical cord blood cortisol as a biomarker for assessing neonatal stress and adaptation.
physiology, particularly in stress response regulation, immune function, and metabolic homeostasis. In
the perinatal period, cortisol becomes a critical determinant of neonatal outcomes, as it drives the
maturation of key fetal organs and facilitates the transition from intrauterine to extra uterine life. A
surge in fetal cortisol levels during late gestation is integral to the development of the lungs, liver, and
brain, which are essential for postnatal survival. Moreover, the umbilical cord, as the primary channel
of maternal-fetal exchange, provides an invaluable window into the hormonal state of the fetus at birth.
An observational prospective study analyzing umbilical cord blood cortisol levels, focusing on
their associations with gestational age, was conducted at the Mother Teresa Hospital in Skopje, and 88
samples were obtained for analysis.
The aim was to compare cortisol levels in healthy and appropriate for gestational age (AGA)
newborns, depending on their gestational age.
The results showed a mean cortisol level of 93.41 [95%CI 82.72 – 104.10]. In term infants the
mean cortisol level was significantly higher, with a mean value of 100.60 [95%CI 88.940 – 112.259],
than in preterm ones where mean cortisol level was 51.91 [95%CI 40.528 – 63.301], with a statistically
significant difference (p<0.0012).
The significant associations between cortisol levels and gestational age highlight the potential
utility of umbilical cord blood cortisol as a biomarker for assessing neonatal stress and adaptation.
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