Related Experiment Video
Updated: Apr 11, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Randomised trial of early neonatal hydrocortisone demonstrates potential undesired effects on neurodevelopment at
Outi M Peltoniemi1,2, Aulikki Lano3, Anneli Yliherva4
1PEDEGO Research Center, and Medical Research Center Oulu, University of Oulu, Oulu, Finland.
Insights
Early hydrocortisone treatment in premature infants may negatively impact neurodevelopment. Follow-up studies revealed lower IQ scores and increased need for physiotherapy in children who received hydrocortisone, suggesting potential adverse effects.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Pediatric Neurology
Background:
- Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants.
- Early hydrocortisone treatment has been explored as a strategy to prevent BPD.
- The long-term neurodevelopmental effects of this intervention require thorough evaluation.
Purpose of the Study:
- To assess the neurodevelopment and growth of children treated with early low-dose hydrocortisone for BPD prevention.
- To compare neurodevelopmental outcomes between hydrocortisone and placebo groups at five to seven years of age.
Main Methods:
- A follow-up study of children born between 23-30 weeks gestation with birthweights of 501-1250 g.
- Participants received either hydrocortisone or placebo for 10 days during the neonatal period.
- Evaluated growth, neuromotor, cognitive, and speech development in survivors at five to seven years.
Main Results:
- Children in the hydrocortisone group showed a higher incidence of neurodevelopmental impairment (61% vs 39%).
- Mean performance IQ was significantly lower in the hydrocortisone group (88.3 vs 99.1, p=0.034).
- 22% of the hydrocortisone group required physiotherapy, compared to none in the placebo group (p=0.034).
Conclusions:
- Early low-dose hydrocortisone treatment may be associated with adverse neurodevelopmental outcomes in preschool-aged children.
- Further research is necessary to confirm these findings and assess the safety profile of early hydrocortisone use.
Aim:
We evaluated the neurodevelopment and growth of five- to seven-year-old children who had participated in a randomised trial of early low-dose hydrocortisone treatment to prevent bronchopulmonary dysplasia.
Methods:
The 51 infants in the original study had birthweights of 501-1250 g and gestational ages of 23-30 weeks, required mechanical ventilation during the first 24 hours and received hydrocortisone or a placebo for 10 days. The majority (80%) of the 90% who survived to five- to seven years of age participated in this follow-up study and their growth, neuromotor, cognitive and speech development were evaluated.
Results:
Some neurodevelopment impairment was observed in 61% of the hydrocortisone group and 39% of the placebo group, ranging from minor neurological dysfunction to severe neurological conditions (p = 0.182). The mean full-scale intelligence quotient (IQ) was 87.8 (15.3) in the hydrocortisone group and 95.7 (15.0) in the placebo group (p = 0.135), and the mean performance IQ was 88.3 (14.5) and 99.1 (14.0) (p = 0.034), respectively. A fifth (22%) of the hydrocortisone group required physiotherapy, but none of the placebo group did (p = 0.034). The age-standardised growth was comparable between both groups.
Conclusion:
Early hydrocortisone treatment may have undesired effects on neurodevelopment at preschool age, and further safety studies are required.
