Related Experiment Video
Updated: Nov 5, 2025
Intratracheal Instillation of Stem Cells in Term Neonatal Rats
Published on: May 4, 2020
Duration of mechanical ventilation is more critical for brain growth than postnatal hydrocortisone in extremely
Chloé Rousseau1, Marine Guichard2, Elie Saliba1,3
1Neonatology Department, CHRU de Tours, Tours, France.
Insights
Hydrocortisone treatment in extremely preterm infants did not independently impact brain growth up to 12 months. However, the severity of the neonatal course, particularly mechanical ventilation duration, significantly influenced brain development, with potential sex-specific effects requiring further study.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Medical Imaging
Background:
- Postnatal hydrocortisone use in preterm infants has been associated with transient disruptions in growth velocities, including head circumference.
- While hydrocortisone appears to have a lesser impact on neurodevelopment compared to dexamethasone, its precise effects on brain growth in extremely preterm infants remain under investigation.
Purpose of the Study:
- To investigate the impact of hydrocortisone treatment on postnatal brain growth in extremely preterm infants.
- To explore the association between hydrocortisone exposure, perinatal factors, and brain development outcomes up to 12 months corrected age.
Main Methods:
- Retrospective study matching 20 extremely preterm infants treated with hydrocortisone with 40 untreated controls.
- Assessment of brain tissue areas via MRI at term-equivalent age and head circumference growth up to 12 months corrected age.
- Univariate and multiple regression analyses to determine associations between hydrocortisone, perinatal factors, and brain growth.
Main Results:
- Infants receiving hydrocortisone had lower birth weight and longer mechanical ventilation duration.
- While hydrocortisone-exposed infants showed smaller basal ganglia/thalamus areas and head circumferences, these findings were independently associated with the duration of mechanical ventilation, not hydrocortisone itself.
- A significant interaction between hydrocortisone and sex was observed, suggesting potential sex-specific effects.
Conclusions:
- Hydrocortisone treatment in extremely preterm infants, particularly those with severe conditions, did not demonstrate an independent negative effect on brain growth up to 12 months corrected age.
- The severity of the neonatal course, indicated by factors like mechanical ventilation duration, is a critical determinant of postnatal brain growth.
- Further research is warranted to explore the potential sex-specific effects of hydrocortisone on brain development in this vulnerable population.
Abstract:
Hydrocortisone is used in preterm infants. However, early disruption of growth velocities was observed in infants exposed to hydrocortisone. This retrospective study aimed to explore the postnatal brain growth of extremely preterm infants requiring hydrocortisone treatment as well as its association with perinatal factors. Extremely preterm infants exposed to hydrocortisone from 2011 to 2016 who survived up to 12 months were included. Each of them was matched with two infants not treated with hydrocortisone exhibiting similar gestational ages and nearly similar birth head circumferences. The outcome variables were brain tissue areas on MRIs performed at term-equivalent age and postnatal head circumference growth up to a corrected age of 12 months. Univariate and multiple regression analyses were performed. Infants treated with hydrocortisone (n=20) were matched with 40 infants not exposed to hydrocortisone. The infants exposed to hydrocortisone exhibited a lower birth weight (p=0.04) and a longer duration of mechanical ventilation (p<0.0001). Infants treated with hydrocortisone exhibited a smaller basal ganglia/thalamus area (p=0.04) at term-equivalent age and a smaller head circumference at a corrected age of 12 months (p=0.003). However, the basal ganglia/thalamus area and the postnatal brain growth were independently associated with the duration of mechanical ventilation and not with hydrocortisone. Interestingly, a significant interaction between hydrocortisone and sex was observed (p=0.04).Conclusion: This study supports previous data that indicated no obvious impact of hydrocortisone on brain growth and highlights the relationship between the severity of the neonatal course and postnatal brain growth in extremely preterm infants. What is Known: • Postnatal hydrocortisone disrupts transiently growth velocities including the head circumference growth. • Postnatal hydrocortisone has less impact on neurodevelopment than dexamethasone. What is New: • Hydrocortisone prescribed for infants in the most severe conditions did not show independent effect on brain growth up to the corrected age of 12 months. However, a different effect of hydrocortisone according to sex can't be excluded and needs further explorations. • Perinatal factors as birth weight and duration of mechanical ventilation were determinant for the subsequent brain growth.
More Related Videos
07:36Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
05:52Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
Published on: October 28, 2022
Related Concept Videos
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
01:23Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
01:29Mechanical Ventilation I: Indication and Settings