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Use of Glucocorticoids for the Fetus and Preterm Infant

Susan M Scott1, Susan R Rose2

  • 1University of New Mexico School of Medicine, 2211 Lomas Boulevard, Albuquerque, NM 87131, USA.

Clinics in Perinatology
|February 7, 2018
PubMed

Insights

Glucocorticoid therapy improves outcomes for preterm infants by aiding lung development and adrenal function. While generally beneficial, dexamethasone may pose greater risks to brain development compared to other glucocorticoids.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Pharmacology

Background:

  • Glucocorticoids have been used for over 40 years to prepare fetuses and preterm infants for life after birth.
  • Treatment addresses cortisol replacement for immature hypothalamic-pituitary-adrenal axes and prevents chronic lung disease.
  • Concerns exist regarding potential neurodevelopmental adverse effects, particularly with dexamethasone.

Purpose of the Study:

  • To review the established benefits and potential risks of glucocorticoid therapy in preterm infants.
  • To compare the safety profiles of different glucocorticoids, focusing on neurodevelopmental outcomes.

Main Methods:

  • Literature review of studies on glucocorticoid use in neonatal care.
  • Analysis of clinical data comparing dexamethasone with other glucocorticoids regarding efficacy and safety.
  • Examination of long-term effects on infant development and organ function.

Main Results:

  • Glucocorticoid treatment significantly improves overall outcomes for preterm infants.
  • Dexamethasone therapy has been associated with more frequent negative effects on brain development and function.
  • The benefits of glucocorticoids for lung function and adrenal sufficiency are well-documented.

Conclusions:

  • Glucocorticoid therapy remains a critical intervention for improving the survival and health of preterm infants.
  • Careful consideration of the specific glucocorticoid agent and potential neurodevelopmental risks is warranted.
  • Ongoing research aims to optimize glucocorticoid use while minimizing adverse effects in vulnerable neonates.

Keywords:
BPDBrain developmentFetusGlucocorticoidsHPA axisHypotensionNewborn

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