Evidence map›Paper›PMID 42311913›Full record

ReviewFrontiers in pediatrics2026

Differences in cortisol levels between preterm and term infants: a systematic review and meta-analysis combined with Mendelian randomization study.

Yun Li, Xiaohui Liang, Limin Cao, Yujing Yang, Shujing Wei, Yong Ji

Abstract readReview
In one paragraph

Review in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yun LiDepartment of Neonatal Intensive Care Unit (NICU), Shanxi Children's Hospital(Maternal and Child Health Hospital of Shanxi Province, Maternity Hospital of Shanxi Province), Taiyuan, China.
Xiaohui LiangDepartment of Pediatrics, Shanxi Medical University, Taiyuan, China.
Limin CaoDepartment of Pediatrics, Shanxi Medical University, Taiyuan, China.
Yujing YangDepartment of Pediatrics, Shanxi Medical University, Taiyuan, China.
Shujing WeiDepartment of Pediatrics, Shanxi Medical University, Taiyuan, China.
Yong JiDepartment of Neonatal Intensive Care Unit (NICU), Shanxi Children's Hospital(Maternal and Child Health Hospital of Shanxi Province, Maternity Hospital of Shanxi Province), Taiyuan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Preterm infants have an immaturity hypothalamic-pituitary-adrenal (HPA) axis, whether cortisol levels differ from those in term infants remains inconsistent. This study employed a meta-analysis to compare cortisol levels between preterm and term infants (PROSPERO: CRD42024606328, https://www.crd.york.ac.uk/PROSPERO/). We then applied Mendelian randomization (MR) to assess a potential causal relationship, with preterm birth as the exposure and cortisone (a key cortisol precursor) as the outcome. Methods: We systematically searched 10 databases from inception to August 2024 for studies reporting cortisol in preterm and term infants. Subgroup analyses and meta-regression were conducted by the type of specimens, measurement methods, measurement ages, gestational ages, measurement times, and the usage of steroid hormones. Random effects models were used for analysis, and data were reported using 95% confidence intervals. Publication bias was assessed using Eggers test, and a leave-one-out sensitivity analysis was performed. MR analysis was conducted to explore the causal relationship between preterm birth and cortisone. Results: A total of 74 studies were included, consisting of 18 umbilical cord blood (UCB) studies, 28 peripheral blood studies, and 31 saliva studies. Preterm infants had lower cortisol levels in UCB (SMD: -0.45; 95% CI: -0.77 to -0.12, Conclusion: Cortisol levels in preterm infants exhibit a trend of being initially lower, then higher, but finally comparable to those of term infants in the long term. MR supports a causal link between preterm birth and cortisone. These findings may guide the clinical management of preterm infants and individualized glucocorticoid strategies. Future high-quality clinical studies are required to further validate and optimize glucocorticoid protocols. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/. PROSPERO: CRD42024606328.

Indexed as

cortisol levelshypothalamic-pituitary-adrenal axismedelian randomizationmeta-analysispreterm infant

Identifiers

PMID42311913
PMCPMC13269068

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.