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The Impact of Postnatal Systemic Steroids on the Growth of Preterm Infants: A Multicenter Cohort Study

Carlos Zozaya1, Alejandro Avila-Alvarez2, Fermín García-Muñoz Rodrigo3

  • 1Division of Neonatology, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.

Nutrients
|November 14, 2019
PubMed

Insights

Systemic postnatal steroids did not significantly impact the growth of preterm infants. However, some subgroups receiving steroids later or not requiring oxygen showed improved weight gain, suggesting nuanced effects.

Area of Science:

  • Neonatology
  • Pediatric Growth and Development
  • Pharmacology

Background:

  • Postnatal steroids are used to manage bronchopulmonary dysplasia in preterm infants.
  • Limited data exist on the effects of postnatal steroids on preterm infant growth.
  • Understanding these effects is crucial for optimizing care for vulnerable neonates.

Purpose of the Study:

  • To investigate the association between systemic postnatal steroid use and growth in preterm infants.
  • To analyze growth parameters including weight, linear growth, and head circumference.
  • To explore potential differences based on steroid timing and respiratory support needs.

Main Methods:

  • Multicenter cohort study of 17,621 preterm infants (<32 weeks gestation) from the Spanish Neonatal Network.
  • Linear regression models adjusted for multiple confounding factors including respiratory severity and BPD diagnosis.
  • Subgroup analyses examined effects based on timing of steroid administration and oxygen dependency.

Main Results:

  • Overall, systemic postnatal steroids showed no independent association with poorer weight, linear, or head circumference growth.
  • Infants receiving steroids later (after 28 days) or not oxygen-dependent at 36 weeks demonstrated increased weight gain.
  • Adjusted analyses indicated no significant global effect of postnatal steroids on overall postnatal growth.

Conclusions:

  • Systemic postnatal steroids, in general, do not adversely affect the growth of preterm infants.
  • Specific timing and respiratory status may influence the growth outcomes in infants treated with steroids.
  • Further research may clarify the nuanced role of postnatal steroids in preterm infant development.

Keywords:
bronchopulmonary dysplasiagrowthpreterm infantsteroids

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