Reviewing the use of corticosteroids in bronchopulmonary dysplasia

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Pharmacology

Background:

• Bronchopulmonary dysplasia (BPD) remains a significant challenge in preterm infants, lacking a definitive therapy.
• Corticosteroids were historically used for BPD due to their impact on disease progression.
• Concerns regarding cerebral palsy linked to corticosteroid use have limited their prescription, potentially increasing BPD incidence.

Purpose of the Study:

• To review the risks and benefits of postnatal corticosteroid use for treating bronchopulmonary dysplasia.
• To evaluate corticosteroid therapy in the context of limited effective treatment options for BPD.

Main Methods:

• Comprehensive literature review conducted across multiple databases (BIREME, LILACS, IBECS, MEDLINE, Cochrane Library, SciELO).
• Search focused on "bronchopulmonary dysplasia and corticosteroid," prioritizing recent publications (last five years).

Main Results:

• The review highlights the historical efficacy of corticosteroids in managing BPD progression.
• It acknowledges the significant risk of adverse neurodevelopmental outcomes, such as cerebral palsy, associated with their use.
• The data suggests a need to re-evaluate corticosteroid indications.

Conclusions:

• The decision to use postnatal corticosteroids for BPD requires a careful balance of risks and benefits.
• Certain infant subgroups, particularly those on mechanical ventilation with difficult weaning, may experience greater benefits than risks.
• Further research into restricted indications for corticosteroid use in BPD is warranted.