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Inhaled Corticosteroid Exposure in Hospitalized Infants with Bronchopulmonary Dysplasia

Chelsey Leiting1, Ellen Kerns1,2, Joshua C Euteneuer1,2

  • 1Children's Hospital and Medical Center, Omaha, Nebraska.

American Journal of Perinatology
|May 6, 2022
PubMed

Insights

Inhaled corticosteroid (IC) use is common in infants with bronchopulmonary dysplasia (BPD) but varies widely between hospitals. Further research is needed to understand the risks and benefits of ICs in this population.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Clinical Pharmacology

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
  • Inhaled corticosteroids (ICs) are sometimes used in BPD management, but their efficacy and safety in this population are not well-established.
  • Significant variation exists in clinical practice regarding IC use for BPD.

Purpose of the Study:

  • To determine the prevalence of inhaled corticosteroid (IC) use in infants diagnosed with bronchopulmonary dysplasia (BPD).
  • To quantify the interhospital variability in IC administration for BPD.
  • To identify clinical, demographic, and hospital factors associated with IC use in infants with BPD.

Main Methods:

  • Retrospective analysis of 4,551 infants born at <32 weeks gestation with developing BPD using the Pediatric Health Information System database.
  • Comparison of clinical, demographic, and hospital characteristics between infants exposed and not exposed to ICs.
  • Assessment of factors associated with IC use, including disease severity and hospital characteristics.

Main Results:

  • Overall, 25% of infants with BPD and 43% with severe BPD received ICs.
  • IC use varied significantly between hospitals, ranging from 0% to 66%.
  • Increased IC exposure was associated with lower birth weight, younger gestational age, longer respiratory support duration, and greater need for other medications.

Conclusions:

  • IC exposure is prevalent in infants with BPD, with considerable interhospital variation.
  • IC use is linked to more severe BPD, but hospital experience does not explain the observed variability.
  • Urgent research is required to clarify the effects of ICs in this vulnerable infant population to guide clinical practice.
Abstract

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