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[Use and misuse of steroids to newborn]

Ketil Størdal1, Jon Lunde

  • 1Barneavdelingen, Sykehuset Østfold Fredrikstad, 1602 Fredrikstad. ketil.stordal@c2i.net

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|November 8, 2007
PubMed

Insights

Glucocorticoids aid premature infants with bronchopulmonary dysplasia short-term but carry significant long-term risks, including cerebral palsy and neurodevelopmental issues. Use cautiously in severe lung disease.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Pharmacology

Context:

  • Extremely preterm neonates have increased survival rates.
  • Chronic lung disease, or bronchopulmonary dysplasia, is a common complication.
  • Glucocorticoids offer short-term benefits but pose significant side effect risks.

Purpose:

  • To review the beneficial and detrimental effects of neonatal glucocorticoid use.
  • Emphasis on long-term side effects and neurodevelopmental outcomes.
  • Provide evidence-based guidance for clinical application.

Summary:

  • Short-term glucocorticoid therapy improves bronchopulmonary dysplasia outcomes, reducing ventilator duration and oxygen needs.
  • However, glucocorticoids do not improve 40-week survival and are linked to increased risks of cerebral palsy and cognitive impairment.
  • No significant long-term effects on lung function, growth, or metabolism have been confirmed.

Impact:

  • Neonatal glucocorticoid use requires careful consideration due to severe long-term risks.
  • Clinical decisions should weigh short-term gains against potential neurodevelopmental and neurological deficits.
  • Recommend use only for severe, ventilator-dependent lung disease after 2-3 weeks of age.
Abstract

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