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Trends, Characteristic, and Outcomes of Preterm Infants Who Received Postnatal Corticosteroid: A Cohort Study from 7

Shalin Parikh1,2, Brian Reichman3, Satoshi Kusuda4

  • 1Department of Pediatrics, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.

Neonatology
|May 11, 2023
PubMed

Insights

Systemic postnatal steroids (PNS) use in preterm infants increased from 2010-2018, but this rise did not correlate with changes in bronchopulmonary dysplasia (BPD) rates. Further research is needed for optimal PNS use in neonates.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication in extremely preterm infants.
  • Systemic postnatal steroids (PNS) are sometimes used to manage BPD, but their efficacy and optimal use remain debated.
  • Understanding trends in PNS use and their association with BPD is crucial for improving infant outcomes.

Purpose of the Study:

  • To analyze the temporal trends of systemic postnatal steroid (PNS) administration in preterm infants (24-28 weeks' gestational age).
  • To identify factors associated with PNS receipt in this vulnerable population.
  • To investigate the correlation between PNS use and the incidence of BPD and BPD/death.

Main Methods:

  • Retrospective analysis of data from 2010-2018 from the international iNeo network cohort.
  • Inclusion criteria: neonates born at 24-28 weeks' gestational age, surviving at least 7 days, and receiving PNS.
  • Assessment of temporal trends in PNS receipt rates and BPD/death incidence.

Main Results:

  • A total of 47,401 neonates were included; mean gestational age was 26.4 weeks.
  • Systemic PNS receipt rate increased from 18% in 2010 to 26% in 2018 (p < 0.01).
  • Bronchopulmonary dysplasia (BPD) rate was 39% and remained stable over the study period. Lower gestation, male sex, small for gestational age, and persistent ductus arteriosus were linked to higher PNS receipt and BPD/death.

Conclusions:

  • Systemic postnatal steroid (PNS) use in extremely preterm neonates has increased, but this trend did not correlate with a change in BPD rates.
  • Factors such as lower gestation, male sex, SGA, and PDA are associated with both higher PNS use and BPD/death.
  • Further research is required to establish optimal timing, dosage, and indications for PNS in preterm infants.
Abstract

Keywords:
Bronchopulmonary dysplasiaInfantPostnatal steroidPreterm

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