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[Early postnatal application of glucocorticoids for preventing bronchopulmonary dysplasia in preterm infants: a Meta

Feng-Juan Ji1, Yong Yin, Juan Xu

  • 1Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. yinyong9999@163.com.

Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics
|June 14, 2017
PubMed

Insights

Early postnatal glucocorticoids may reduce bronchopulmonary dysplasia (BPD) in preterm infants but increase risks of hyperglycemia, hypertension, and intestinal perforation. Further research is needed to weigh these benefits against adverse effects.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
  • Early intervention strategies are crucial for improving outcomes in premature neonates.

Purpose of the Study:

  • To evaluate the clinical efficacy and safety of early postnatal glucocorticoid administration for preventing BPD in preterm infants.
  • To synthesize evidence from randomized controlled trials (RCTs) on glucocorticoid use for BPD prevention.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed, Cochrane Library, Embase, etc.) up to June 2016.
  • Meta-analysis of 16 RCTs involving 2,962 preterm infants was performed using Review Manager 5.3.

Main Results:

  • Early postnatal glucocorticoids significantly reduced the incidence of BPD at 36 weeks corrected gestational age (OR=0.73, P=0.0004).
  • However, this intervention was associated with increased risks of hyperglycemia (OR=1.61, P=0.0003), hypertension (OR=1.63, P=0.01), and intestinal perforation (OR=1.51, P=0.007).

Conclusions:

  • Current evidence does not support the routine use of early postnatal glucocorticoids for BPD prevention in preterm infants.
  • Further investigation is warranted to fully understand the risk-benefit profile, particularly concerning adverse effects like hyperglycemia, hypertension, and intestinal perforation.
Abstract

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