Neonatal corticosteroid therapy affects growth patterns in early infancy

Area of Science:

• Neonatal Medicine
• Pediatric Endocrinology
• Growth and Development

Background:

• Postnatal corticosteroid (CS) therapy improves pulmonary function in preterm infants but may cause growth restriction.
• Early childhood growth patterns are linked to adult cardiovascular and metabolic health.

Purpose of the Study:

• To evaluate the impact of postnatal dexamethasone (DEX) or hydrocortisone (HC) on infant growth patterns up to age four.
• To compare the effects of DEX and HC on weight, height, and head circumference growth velocities.

Main Methods:

• Observational cohort study of preterm infants (<32 weeks gestation).
• Compared growth patterns (weight, height, head circumference) from birth to four years.
• Utilized linear mixed-effects modeling for analysis.

Main Results:

• CS treatment, especially DEX, caused a delay in growth velocity and reduced absolute growth rates in neonates.
• Maximal growth velocity was reached later in CS-treated boys and girls.
• Catch-up growth was observed in later months, with DEX showing more pronounced effects than HC.

Conclusions:

• Postnatal CS treatment significantly affects growth patterns and velocities in preterm infants.
• Dexamethasone has a more pronounced impact on growth than hydrocortisone.
• Long-term health implications of these growth alterations warrant further investigation, ideally through randomized trials.