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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Cumulative perinatal steroids: child development of preterm infants

Isabell B Purdy1, Dorothy J Wiley, Lynne M Smith

  • 1University of California, Los Angeles, CA 90095-1752, USA. ipurdy@mednet.ucla.edu

Journal of Pediatric Nursing
|May 22, 2008
PubMed

Insights

High doses of perinatal steroids in premature infants may negatively impact behavioral development, particularly social skills. Closer monitoring of steroid therapy and illness severity is recommended for long-term infant support.

Area of Science:

  • Neonatal Development
  • Pediatric Neurology
  • Pharmacological Impact on Development

Background:

  • Premature infants may receive high cumulative doses of corticosteroids like dexamethasone during critical growth periods.
  • Perinatal steroid exposure can potentially alter neurodevelopmental trajectories in early life.
  • Understanding the long-term behavioral effects of these exposures is crucial for optimizing infant care.

Purpose of the Study:

  • To compare the school-age behavioral development of premature infants exposed to higher versus lower doses of perinatal steroids.
  • To identify specific behavioral outcomes associated with varying levels of perinatal steroid exposure.
  • To investigate the influence of illness severity and birth parameters on behavioral outcomes in this cohort.

Main Methods:

  • A historical cohort of 45 prematurely born infants was studied.
  • The Vineland Adaptive Behavioral Scales were utilized to assess school-age behavioral outcomes.
  • Infants were categorized based on perinatal steroid exposure: higher (>0.2 mg/kg) and lower (<=0.2 mg/kg).

Main Results:

  • Infants exposed to higher perinatal steroid doses demonstrated significantly lower overall behavioral developmental scores.
  • Social skills development was particularly affected, showing a significant decline in the higher exposure group (p < .05).
  • Higher perinatal steroid exposure, combined with greater illness severity (Clinical Risk Index for Babies) and smaller birth head circumference, correlated with poorer behavioral outcomes.

Conclusions:

  • Higher perinatal corticosteroid exposure in premature infants is associated with impaired behavioral development, notably in social skills.
  • Clinical factors such as severity of illness and birth head size interact with steroid exposure to influence long-term behavioral outcomes.
  • Nursing practices should emphasize careful evaluation of cumulative steroid therapy, illness severity, and provide robust long-term follow-up for premature infants.

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