RT Journal Article SR Electronic T1 Blood spot glucocorticoid concentrations in ill preterm infants. JF Archives of Disease in Childhood JO Arch Dis Child FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health SP 1014 OP 1018 DO 10.1136/adc.62.10.1014 VO 62 IS 10 A1 Hughes, D A1 Murphy, J F A1 Dyas, J A1 Robinson, J A A1 Riad-Fahmy, D A1 Hughes, I A YR 1987 UL http://adc.bmj.com/content/62/10/1014.abstract AB The adrenocortical response to stress was studied longitudinally in 10 ill preterm infants using measurements of cortisol and 170H-progesterone concentrations in filter paper blood spots. Mean cortisol and 170H-progesterone concentrations reached a peak of 2200 nmol/l and 65 nmol/l, respectively, between the third and fifth days of life. These concentrations far exceeded those observed in older children and adults subjected to stress as a result of surgery. Further pulses of endogenous cortisol production of 4000 nmol/l or more occurred in association with clinical complications such as intraventricular haemorrhage. These results indicate that infants undergoing intensive care are unduly stressed. Consideration should be given to providing enough sedation and appropriate analgesia for ill preterm infants during painful procedures such as insertion of venous cannulae and arterial puncture.