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Effect on growth of two different dexamethasone courses for preterm infants at risk of chronic lung disease. A
C Romagnoli1, E Zecca, G Vento
1Department of Paediatrics, Division of Neonatology, Catholic University of the Sacred Heart, Rome, Italy. cromagnoli@rm.unicatt.it
Insights
Dexamethasone treatment in preterm infants with chronic lung disease risk temporarily slows weight gain but leads to catch-up growth. Higher doses may negatively impact head growth, suggesting potential adverse effects on brain development.
Area of Science:
- Neonatal Medicine
- Pediatric Pharmacology
- Growth and Development
Background:
- Preterm infants are at high risk for chronic lung disease (CLD).
- Dexamethasone is used to manage CLD in preterm infants, but its effects on growth require evaluation.
- Understanding the optimal dexamethasone regimen is crucial for balancing therapeutic benefits and adverse effects.
Purpose of the Study:
- To evaluate the impact of two different dexamethasone treatment courses on the growth of preterm infants at risk for CLD.
- To compare the effects of moderately early versus early dexamethasone administration on infant growth parameters.
- To identify potential dose-related adverse effects of dexamethasone on infant development.
Main Methods:
- A randomized study involving two phases, each with a dexamethasone-treated group and a control group.
- Phase 1: 15 infants received 14 days of dexamethasone (4.75 mg/kg total dose) from day 10; 15 controls.
- Phase 2: 15 infants received 7 days of dexamethasone (2.38 mg/kg total dose) from day 4; 15 controls.
Main Results:
- Dexamethasone treatment significantly reduced weight gain during therapy but was followed by catch-up growth.
- At 30 days of life, weight and length gains were similar between treated and control groups.
- The moderately early, higher-dose dexamethasone group showed significantly poorer head growth at 30 days.
Conclusions:
- Dexamethasone treatment causes a temporary reduction in weight gain, with subsequent catch-up growth.
- Higher-dose, moderately early dexamethasone may have adverse effects on postnatal brain growth, indicated by poorer head growth.
- Further research into dose-related adverse effects of dexamethasone on preterm infant neurodevelopment is warranted.
Abstract:
A randomized study was designed to evaluate the effects of two different dexamethasone courses on the growth of preterm infants. The first phase included 30 preterm infants at high risk for chronic lung disease (CLD). 15 babies (moderately early dexamethasone group) were treated with dexamethasone for 14 days, from the 10th day of life, and received a total dose of 4.75 mg/kg; 15 babies were assigned to the control group. The second phase included 30 preterm infants at high risk for CLD. 15 babies (early dexamethasone group) were treated with dexamethasone for 7 days, from the 4th day of life, and received a total dose of 2.38 mg/kg; 15 babies were assigned to the control group. All the main clinical baseline characteristics were similar between the groups both in the first and in the second phase. Infants given the two dexamethasone courses showed significantly reduced weight gain during the period of treatment when compared to the respective control group, but they had a weight catch-up soon after the end of treatment. At 30 days of life the weight and length gain of each treated group were similar to those of control infants, but the moderately early dexamethasone group showed a significantly poorer head growth. No differences between the groups were observed at discharge. Dexamethasone treatment induces a slower weight gain which is time-limited to the period of treatment and is followed by a body weight catch-up. However, the poorer head growth detected at 30 days of life in the infants who received a higher dose of dexamethasone could indicate important adverse effects, possibly dose-related, on postnatal brain growth and development.