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Hydrocortisone vs. dexamethasone treatment for bronchopulmonary dysplasia and their effects on general movements in

Marrit M Hitzert1, Manon J N L Benders, Annemiek M Roescher

  • 1Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. m.m.hitzert@umcg.nl

Pediatric Research
|February 1, 2012
PubMed

Insights

Hydrocortisone (HC) therapy showed better long-term neurological outcomes in preterm infants compared to dexamethasone (DXM) therapy, as assessed by general movements (GMs) quality up to 3 months post-term.

Area of Science:

  • Neonatal Neurology
  • Developmental Pediatrics
  • Pharmacological Effects on Neurodevelopment

Background:

  • Corticosteroids like hydrocortisone (HC) and dexamethasone (DXM) are used to manage bronchopulmonary dysplasia (BPD) risk in preterm infants.
  • Concerns exist regarding the potential long-term neurological impact of these treatments on developing infants.

Purpose of the Study:

  • To evaluate the effect of HC and DXM therapy on the neurological functioning of preterm infants.
  • To assess neurological development using the quality of general movements (GMs) up to 3 months corrected age.

Main Methods:

  • A longitudinal, observational study involving 56 preterm infants (17 HC, 17 DXM, 22 controls).
  • General movements (GMs) quality was assessed via video recordings before and after treatment.
  • Motor Optimality Score (MOS) was assigned to evaluate details of the GMs.

Main Results:

  • No significant difference in GM quality was observed between HC and DXM groups until term-corrected age.
  • At 3 months corrected age, HC-treated infants demonstrated a higher median Motor Optimality Score (MOS) compared to DXM-treated infants (25 vs. 21, P = 0.015).
  • The DXM group showed a decrease in MOS on the first day of treatment compared to pre-treatment levels (10 vs. 11, P = 0.030).

Conclusions:

  • Motor Optimality Score (MOS) decreased in dexamethasone (DXM)-treated infants during treatment and at 3 months corrected age, unlike in hydrocortisone (HC)-treated infants.
  • Neurological functioning at 3 months corrected age appears to be better in preterm infants treated with HC compared to those treated with DXM.
Abstract

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