Related Experiment Video
Updated: Aug 15, 2025
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Effects of postnatal glucocorticoids on brain structure in preterm infants, a scoping review
Isabella Robles1, Margarita Alethea Eidsness1, Katherine E Travis1
1Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, United States.
Insights
Postnatal glucocorticoids (GC) in preterm infants may affect brain structure. Dexamethasone is linked to reduced brain volumes, while hydrocortisone shows mixed results, highlighting the need for more research on GC’s impact on neurodevelopment.
Area of Science:
- Neonatal medicine
- Neuroscience
- Pharmacology
Background:
- Glucocorticoids (GC) are administered to preterm infants to manage chronic lung disease.
- Concerns exist regarding the potential impact of GC on neurodevelopmental outcomes.
- Understanding GC's effects on brain structure is crucial for clinical practice.
Purpose of the Study:
- To comprehensively review existing literature on postnatal GC treatment and structural brain development in preterm infants.
- To identify knowledge gaps concerning GC's influence on the developing preterm brain.
- To inform future research and clinical guidelines.
Main Methods:
- A scoping review following the Arksey and O'Malley framework.
- Searched scientific literature databases for original research.
- Included studies on human preterm infants, postnatal GCs, and brain structure.
Main Results:
- 11 studies evaluated GC effects on structural brain outcomes.
- Dexamethasone consistently showed associations with decreased total and regional brain volumes, including the cerebellum.
- Hydrocortisone use was often, but not always, associated with no significant brain volume differences.
- No studies investigated the impact of inhaled GC on brain structure.
Conclusions:
- Postnatal GC treatment in preterm infants has implications for structural brain development.
- Dexamethasone appears to be associated with reduced brain volumes.
- Further research is needed to elucidate the effects of various GCs on brain structure and neurodevelopmental trajectories.
Abstract:
Glucocorticoids (GC) are used in neonatal intensive care units to prevent or reduce the severity of chronic lung disease in preterm infants and have been implicated in impaired neurodevelopment. Our objective was to identify what is known about the effects of postnatal GC treatment in human preterm infants on structural brain development and to identify gaps in the literature. Following Arksey and O'Malley's scoping review methodological framework, we searched scientific literature databases for original research on human preterm infants, postnatal GCs, and brain structure. 11 studies assessed the effects of GCs on structural brain outcomes. 56 studies reported brain injury, but not structure. Dexamethasone was consistently associated with decreased total and regional brain volumes, including cerebellar volumes. Hydrocortisone was often, but not always associated with absence of brain volume differences. No studies examined the impact of inhaled GC on brain structure. Additional research on the effects of neonatal GCs after preterm birth on a variety of structural brain measures is required for understanding contributions to neurodevelopment and informing practice guidelines.
