Evaluation of Cortisol Level in Premature Neonates: Are There any Correlations between Prevalence of Patent Ductus Arteriosus and Prenatal Administration of Betamethasone?

  The results of previous studies suggested that there is an increased risk of patent ductus arteriosus (PDA) in the neonates with lower serum cortisol levels. This study aimed to assess the association between serum cortisol values and PDA and investigate if there is an association between PDA and the antenatal administration of betamethasone. The present study was carried out on the neonates with gestational age between 28 to 35 weeks. The prenatal administration of betamethasone to the mothers was extracted from the records. A pediatric cardiologist performed an echocardiographic assessment on the second day of life (DOL) and fifth DOL and the infants were evaluated for the presence of PDA. The blood samples were obtained on the second and fifth DOL and serum cortisol levels were measured. We evaluated the association between serum cortisol levels and PDA. Also, the correlation between PDA and the antenatal administration of betamethasone was assessed. The mean scores of serum cortisol levels on the second DOL in the neonates with and without PDA were 4.99±2.69 (μg/dl) and 7.23±2.87 (μg/dl), respectively that were significantly lower in the first group, compared to those of the second group. However, the mean levels of serum cortisol in the neonates with and without the prenatal administration of betamethasone were not significant (P=0.522). We have concluded that lower serum cortisol level was associated with the increase in the risk of PDA and the prenatal administration of glucocorticoids may not reduce the occurrence of PDA.