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Postnatal dexamethasone, respiratory and neurodevelopmental outcomes at two years in babies born extremely preterm

Gordon Qin1,2, Jessica W Lo1,3, Neil Marlow4

  • 1Division of Health and Social Care Research, King's College London, London, United Kingdom.

Plos One
|July 21, 2017
PubMed

Insights

Postnatal dexamethasone in extremely preterm infants increased respiratory hospital admissions and neurodevelopmental impairment risks. These findings highlight potential long-term adverse effects despite short-term benefits for bronchopulmonary dysplasia.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Developmental Pediatrics

Background:

  • Postnatal dexamethasone is used to reduce bronchopulmonary dysplasia in preterm infants.
  • Concerns exist regarding potential long-term adverse neurodevelopmental outcomes associated with its use.

Purpose of the Study:

  • To evaluate the impact of postnatal dexamethasone on respiratory and neurodevelopmental outcomes at two years of age.
  • To adjust for various neonatal and infant risk factors in the analysis.

Main Methods:

  • A cohort of 412 infants born between 23-28 weeks of gestation was studied.
  • Logistic regression analysis was used to assess respiratory hospital admissions and neurodevelopmental impairment.
  • Adjustments were made for multiple confounding variables including sex, birthweight, gestation, and neonatal morbidities.

Main Results:

  • Postnatal dexamethasone use was significantly associated with increased respiratory hospital readmissions (0.35 vs 0.15).
  • A higher proportion of infants receiving dexamethasone experienced neurodevelopmental impairment (0.59 vs 0.45).
  • These associations persisted after adjusting for neonatal morbidities.

Conclusions:

  • Postnatal dexamethasone administration in extremely preterm infants is linked to elevated risks of respiratory hospital admissions.
  • The study also found an association between postnatal dexamethasone and increased neurodevelopmental impairment.
  • These adverse outcomes were not attributable to increased neonatal complications.
Abstract

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