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Decreased use of postnatal corticosteroids in extremely preterm infants without increasing chronic lung disease

Rakesh Seth1, Peter H Gray, David I Tudehope

  • 1Division of Neonatology, Mater Mothers' Hospital, University of Queensland, Qld., Australia.

Neonatology
|September 9, 2008
PubMed

Insights

Reducing postnatal corticosteroid use in extremely preterm infants did not affect chronic lung disease (CLD) rates. However, a trend towards lower cerebral palsy incidence was observed, warranting further study.

Area of Science:

  • Neonatal medicine
  • Pediatric pulmonology
  • Neurodevelopmental pediatrics

Background:

  • Postnatal corticosteroids are used to prevent chronic lung disease (CLD) in preterm infants.
  • Concerns exist regarding potential neurodevelopmental impairments associated with corticosteroid use.

Purpose of the Study:

  • To evaluate the impact of changing postnatal corticosteroid practices over eight years on CLD and cerebral palsy in extremely preterm infants.
  • To assess outcomes at one year of age following adjustments in corticosteroid administration.

Main Methods:

  • Retrospective analysis of infants with birth weight <1,000g or gestational age <28 weeks (1997-2004).
  • Study divided into two eras (1997-2000 and 2001-2004) to compare corticosteroid usage and outcomes.
  • Chronic lung disease defined as oxygen dependency at 36 weeks postmenstrual age.

Main Results:

  • Dexamethasone use significantly decreased from 27% to 13% between the two study periods.
  • Incidence of CLD and need for home oxygen remained similar between groups.
  • Cerebral palsy incidence showed a non-significant reduction from 10.4% to 6.6%.

Conclusions:

  • Reduced postnatal corticosteroid use did not alter CLD incidence or home oxygen requirements.
  • Observed trend of decreased cerebral palsy rates requires additional investigation.
  • Further research is needed to understand the relationship between corticosteroid reduction and neurodevelopmental outcomes.
Abstract

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