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Updated: Oct 23, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Postnatal glucocorticoid use impacts renal function in VLBW neonates.
Christiane Mhanna1, Merlin Pinto2, Hannah Koechley2
1Department of Pediatrics, The Cleveland Clinic Children's Hospital, Cleveland, OH, USA.
High-dose glucocorticoids in preterm infants are linked to increased blood pressure and altered renal function. Prudent use is recommended to mitigate long-term cardiovascular and kidney risks in VLBW infants.
Area of Science:
- Neonatal Medicine
- Pediatric Pharmacology
- Clinical Pediatrics
Background:
- Preterm neonates often require glucocorticoids for managing hypotension and bronchopulmonary dysplasia.
- Investigated the impact of cumulative glucocorticoid dose and duration on blood pressure and renal function in very low birthweight (VLBW) infants.
Purpose of the Study:
- To evaluate the association between postnatal glucocorticoid therapy and blood pressure and renal function in VLBW infants.
- To determine the effect of cumulative dose and duration of glucocorticoid exposure on these outcomes.
Main Methods:
- Retrospective cohort study of infants with gestational age ≤35 weeks born between 2015 and 2019.
- Extracted data on demographics, clinical characteristics, steroid dose/duration, blood pressure, and creatinine at NICU discharge.
- Analyzed associations between steroid exposure and cardiovascular/renal parameters.
Main Results:
- Infants receiving postnatal steroids had higher rates of hypertension (28% vs. 16%).
- A correlation was found between cumulative steroid dosage and systolic blood pressure.
- Increased steroid dose and duration were associated with higher creatinine clearance at discharge.
Conclusions:
- Cumulative dose and duration of postnatal steroids are linked to elevated systolic blood pressure in preterm infants.
- Prudent use of postnatal steroids is crucial to prevent long-term cardiovascular and renal morbidity.
- Glucocorticoid use may improve creatinine clearance but could increase the risk of chronic kidney disease.
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