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Neonatologists are using much less dexamethasone.

E S Shinwell1, M Karplus, D Bader

  • 1Kaplan Medical Center, Rehovot, Israel. Soroka Medical Center, Beersheva, Israel. eric_w@clalit.org.il

Archives of Disease in Childhood. Fetal and Neonatal Edition
|August 26, 2003
PubMed
Summary
This summary is machine-generated.

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Reduced dexamethasone use in preterm infants with respiratory distress syndrome correlated with a slight increase in chronic lung disease but a significant decrease in mortality. Further observation is needed to confirm these trends.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Respiratory distress syndrome (RDS) is a common condition in preterm infants.
  • Dexamethasone has been used to treat RDS, but concerns exist regarding its long-term effects.
  • Changes in clinical practice regarding dexamethasone use have occurred over time.

Purpose of the Study:

  • To compare outcomes in preterm infants with RDS between two historical cohorts with different rates of dexamethasone administration.
  • To assess the impact of reduced dexamethasone use on chronic lung disease and mortality.

Main Methods:

  • Retrospective analysis of two historical cohorts of preterm infants (1993-1994 and 2001) diagnosed with RDS.
  • Comparison of dexamethasone administration rates, chronic lung disease incidence, and mortality between the cohorts.

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Main Results:

  • Dexamethasone administration decreased from 22% in the earlier cohort to 6% in the later cohort.
  • Chronic lung disease in survivors increased slightly from 13% to 17%.
  • Overall mortality (excluding other causes) decreased from 21% to 15%.

Conclusions:

  • A reduction in dexamethasone use in preterm infants with RDS was associated with a slight rise in chronic lung disease.
  • Importantly, this reduction in steroid use coincided with a significant decrease in mortality.
  • The long-term impact of restricted dexamethasone use on chronic lung disease and mortality requires continued investigation.