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Hydrocortisone and long-term outcomes in very-low-birthweight infants

Chika Yamasaki1, Atsushi Uchiyama, Hidehiko Nakanishi

  • 1Department of Neonatology, Maternal, and Perinatal Center, Tokyo Women's Medical University, Tokyo, Japan. chikafuku@nyc.odn.ne.jp

Pediatrics International : Official Journal of the Japan Pediatric Society
|March 2, 2012
PubMed

Insights

Physiological hydrocortisone (HDC) doses effectively treat chronic lung disease (CLD) in very-low-birthweight (VLBW) infants. This treatment did not negatively impact infant growth or development by 18 months corrected age.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • The long-term effects of hydrocortisone (HDC) in very-low-birthweight (VLBW) infants with chronic lung disease (CLD) require further investigation.
  • Understanding the impact of HDC on acute CLD exacerbations in VLBW infants is crucial.

Purpose of the Study:

  • To evaluate the short-term clinical effects of physiological replacement doses of HDC.
  • To assess the long-term impact of HDC on VLBW infants with CLD.

Main Methods:

  • Prospective case-control study of 110 VLBW infants followed to 18 months corrected age.
  • Infants categorized into three groups: CLD treated with HDC, CLD untreated, and non-CLD.
  • Exclusion criteria included infant deaths and congenital deformities.

Main Results:

  • Hydrocortisone treatment significantly improved oxygenation (F(I)O(2)) in VLBW infants with CLD.
  • No significant differences in growth or neurodevelopmental quotient were observed at 18 months corrected age among the groups.
  • All developmental quotient areas showed no significant intergroup differences.

Conclusions:

  • Physiological hydrocortisone replacement doses are effective for acute oxygenation deterioration in VLBW infants with CLD.
  • HDC treatment at physiological doses does not adversely affect growth and development up to 18 months corrected age.
Abstract

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