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Respiratory effects of prolonged prednisolone use in infants with evolving and established Bronchopulmonary dysplasia

Caren Liviskie1, Zachary Vesoulis2, Brandy Zeller1

  • 1Department of Pharmacy, St. Louis Children's Hospital, One Children's Place, St. Louis, MO 63110, USA.

Early Human Development
|March 8, 2021
PubMed

Insights

Extended prednisolone treatment in preterm infants significantly reduced pulmonary severity scores without impacting growth. This suggests a potential benefit for respiratory outcomes in this vulnerable population.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Current research on systemic corticosteroids for bronchopulmonary dysplasia (BPD) primarily focuses on prevention in preterm infants.
  • Limited data exists on the efficacy of corticosteroids for established pulmonary disease beyond the first month of life.

Purpose of the Study:

  • To evaluate the effects of extended prednisolone treatment on respiratory and anthropometric outcomes in preterm infants with pulmonary complications.
  • To characterize the population of preterm infants receiving prolonged prednisolone therapy.

Main Methods:

  • A single-center, retrospective study was conducted.
  • Included preterm infants receiving ≥30 days of prednisolone or methylprednisolone for respiratory complications.
  • Assessed pulmonary severity score (PSS), weight, length, and head circumference weekly during and after treatment.

Main Results:

  • Thirty-four preterm infants (mean gestational age 26.5 weeks) were analyzed.
  • A significant decrease in PSS was observed during prednisolone treatment (p < 0.001) without rebound.
  • Eleven infants reduced their respiratory support mode; no significant adverse effects on anthropometric outcomes were noted.

Conclusions:

  • Prolonged prednisolone use demonstrated a sustained improvement in PSS in preterm infants.
  • These findings suggest that extended prednisolone may offer respiratory benefits for select preterm infants with pulmonary disease.
  • No adverse impact on growth measurements was identified with prolonged use.
Abstract

Keywords:
Bronchopulmonary dysplasiaCorticosteroidsInfantPrednisolonePrematurity

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