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Current dilemmas in postnatal steroid therapy for chronic lung disease in preterm infants
1Kaplan Medical Center, Rehovot, Hebrew University, Jerusalem, Israel. eric_s@clalit.org.il
Insights
Postnatal steroid therapy for preterm infants
Area of Science:
- Neonatal medicine
- Pediatric pulmonology
- Pharmacology
Background:
- Postnatal steroid therapy is a common treatment for chronic lung disease in preterm infants.
- Emerging evidence suggests potential risks may exceed benefits.
- Guidelines issued in 2002 by the American Academy of Pediatrics and Canadian Paediatric Society have sparked debate.
Purpose of the Study:
- To review current clinical trial data on postnatal steroid therapy.
- To examine the controversies surrounding established guidelines for steroid use.
Main Methods:
- Literature review of clinical trials.
- Analysis of guidelines from pediatric societies.
Main Results:
- Synthesis of evidence on efficacy and adverse effects of steroids.
- Discussion of the implications and controversies of the 2002 guidelines.
Conclusions:
- The balance of risks and benefits of postnatal steroid therapy requires careful consideration.
- Further research and updated guidelines may be necessary.
Abstract:
Postnatal steroid therapy has been widely used for the prevention and treatment of chronic lung disease in preterm infants. Recently, evidence has accumulated to suggest that the risks of therapy may outweigh the possible benefits. In 2002, the American Academy of Pediatrics and the Canadian Paediatric Society issued guidelines for steroid use. While clarifying a confusing situation, these guidelines have given rise to much controversy. This review will summarize current information on the clinical trials of steroids and also consider the issues surrounding the guidelines.