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Effects of corticosteroids in very low birth weight newborns dependent on mechanical ventilation

Marta M G B Mataloun1, Cléa R Leone, Maria Augusta C Gibelli

  • 1Child's Institute, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil. mataloun@uol.com.br

Clinics (Sao Paulo, Brazil)
|May 10, 2005
PubMed

Insights

Corticosteroids did not significantly impact bronchopulmonary dysplasia rates in very low birth weight infants. However, this treatment did slow infant growth velocity, highlighting a critical trade-off for this vulnerable population.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Corticosteroids are utilized for preventing bronchopulmonary dysplasia due to their anti-inflammatory properties.
  • While effective in reducing bronchopulmonary dysplasia incidence, their use in preterm newborns is associated with adverse effects.
  • The long-term implications and specific impacts on growth and respiratory outcomes require further investigation.

Purpose of the Study:

  • To evaluate the effects of corticosteroids on bronchopulmonary dysplasia, length of stay, mortality, and growth in very low birth weight newborns.
  • To assess adverse effects associated with corticosteroid use in mechanically ventilated infants.
  • To analyze respiratory evolution and growth patterns in response to early corticosteroid administration.

Main Methods:

  • A cohort study included 38 very low birth weight newborns (<1500g) requiring mechanical ventilation between 10-14 days of life.
  • Newborns were divided into two groups: corticosteroid treatment (n=16) and no corticosteroid treatment (n=22).
  • Dexamethasone was administered in a tapering dose from day 10, and outcomes including respiratory status, BPD, growth, and adverse events were analyzed.

Main Results:

  • The incidence of bronchopulmonary dysplasia was lower in the corticosteroid group (6.5%) compared to the control group (30%), though not statistically significant (P = .07).
  • A statistically significant reduction in growth velocity was observed in infants receiving corticosteroids (weight change: 47 g/week vs. 85.5 g/week, P = .06; head circumference change: 0.75 cm/week vs. 1 cm/week, P = .05).

Conclusions:

  • Early corticosteroid use in mechanically ventilated, very low birth weight infants did not significantly alter respiratory evolution or the occurrence of bronchopulmonary dysplasia.
  • A notable decrease in growth velocity was observed in infants treated with corticosteroids.
  • The findings suggest a potential trade-off between BPD prevention and growth impairment, warranting careful consideration of corticosteroid therapy in this population.
Abstract

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