The fetal and neonatal hypothalamic–pituitary–adrenal axis

• Published in: Archives of disease in childhood. Fetal and neonatal edition Vol. 82; no. 3; pp. F250 - F254
• Main Author: Ng, P C
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.05.2000; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adrenal Cortex Hormones - physiology; Adrenal glands; Adrenals. Interrenals; Adrenocortical hormones. Regulation; Algorithms; Biological and medical sciences; Birth weight; Blood pressure; Corticoids; Current Topic; Embryonic and Fetal Development; Feedback; Female; Fetuses; Fundamental and applied biological sciences. Psychology; Glucocorticoids - adverse effects; Growth factors; Homeostasis; Hormones; Humans; Hypothalamo-Hypophyseal System - drug effects; Hypothalamo-Hypophyseal System - physiology; Infant, Newborn; Infants; Nervous system; Newborn babies; Offspring; Physiology; Pituitary gland; Pituitary-Adrenal System - drug effects; Pituitary-Adrenal System - physiology; Placenta; Pregnancy; Prenatal Exposure Delayed Effects; Vertebrates: endocrinology; Human; Corticosteroid; Newborn; Hypothalamohypophysoadrenal axis; Steroid hormone; Adrenal hormone; Hormonal regulation; Fetus; Glucocorticoid; Endocrine secretion
• ISSN: 1359-2998; 1468-2052
• DOI: 10.1136/fn.82.3.F250

Despite the dramatic remodelling of the adrenal cortex that occurs immediately after birth, there is no evidence of clinical adrenocortical insufficiency in term infants during this crucial period. 3 In contrast, ill and extremely premature infants form a unique group because of their potentially decreased ability to produce stress induced release of glucocorticoid.\n 32-38 It has been shown that early infant separation stress is associated with an increase in adult psychopathology, and a permanent rise in β endorphin and cortisol in the circulation. 39 Animal experiments on rodents further indicate that perinatal manipulation of the HPA axis by exogenous corticosteroids and stress might permanently alter the development of central monoamine neurones 33 and reduce the CRH content in the median eminence, which subsequently might be associated with a decrease in stress induced CRH release in adulthood. 40 The administration of exogenous corticosteroids to pregnant rats decreases the birth weight and raises the blood pressure of their offspring in later life. 35 A relation between birth weight, blood pressure, glucose tolerance, and HPA axis hormones is also seen in humans.