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Long-term sequelae of postnatal surfactant and corticosteroid therapies for BPD

E J Short1, H L Kirchner, G R Asaad

  • 1Department of Psychology, Case Western Reserve University, Cleveland, OH 44106, USA. Elizabeth.Short@case.edu

Journal of Perinatology : Official Journal of the California Perinatal Association
|March 28, 2008
PubMed

Insights

Postnatal steroids combined with surfactant in neonates may increase oxygen needs. Surfactant alone showed no adverse effects, but postnatal steroids warrant careful monitoring in infants with bronchopulmonary dysplasia.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Clinical Outcomes Research

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease in premature infants.
  • Neonatal medical interventions like surfactant and postnatal steroids are common in BPD management.
  • Long-term neurodevelopmental and medical outcomes require further investigation.

Purpose of the Study:

  • To evaluate the association between neonatal medical treatments (surfactant, postnatal steroids) and outcomes at 3 and 8 years.
  • To compare outcomes in children with BPD based on different neonatal treatment groups.

Main Methods:

  • Retrospective analysis of a longitudinal sample of children with BPD.
  • Four treatment groups were defined: no drug intervention, surfactant only, postnatal steroids only, and combined surfactant and postnatal steroids.
  • Neurological and medical outcomes were compared across groups.

Main Results:

  • Combined postnatal steroid and surfactant treatment was linked to increased supplemental oxygen days compared to no intervention or surfactant alone.
  • Surfactant replacement therapy alone did not show adverse consequences.
  • Postnatal steroid exposure appeared to be associated with negative outcomes.

Conclusions:

  • Retrospective data limits definitive causal statements.
  • Differential relationships between therapies and cognitive outcomes suggest a need for caution.
  • Careful monitoring of therapeutic agents is recommended for very low birth weight infants.
Abstract

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