Systemic corticosteroid use and neurodevelopmental outcomes in preterm infants: a cohort study

Area of Science:

• Neonatalogy
• Pediatric Pulmonology
• Developmental Pediatrics

Background:

• The use of postnatal corticosteroids for chronic lung disease (PNCSCLD) in preterm infants presents a complex risk-benefit profile.
• This study addresses the controversial nature of PNCSCLD and its impact on infant neurodevelopment.
• Investigating trends and outcomes of PNCSCLD is crucial for clinical practice guidelines.

Purpose of the Study:

• To examine the eleven-year trend in PNCSCLD administration in preterm infants.
• To analyze the association between PNCSCLD and neurodevelopmental outcomes at 18-42 months corrected age.
• To inform clinical decision-making regarding PNCSCLD in neonatal intensive care.

Main Methods:

• Retrospective population-based cohort study utilizing data from ten tertiary neonatal intensive care units.
• Inclusion criteria: preterm infants (<29 weeks gestation) born between 2007-2017, alive at discharge, without major congenital anomalies.
• Neurodevelopmental assessment at 18-42 months corrected age for infants with and without PNCSCLD exposure.

Main Results:

• Over eleven years, 14.3% of 4258 eligible infants received PNCSCLD.
• The incidence of PNCSCLD use rose from 12.4% in 2007 to 19.6% in 2017.
• PNCSCLD was significantly associated with an increased odds ratio for moderate to severe functional disability (MSFD) (OR=1.252, P≤0.001).

Conclusions:

• Increased use of PNCSCLD correlates with a higher incidence of MSFD in preterm infants.
• The findings highlight a concerning association between PNCSCLD and adverse neurodevelopmental outcomes.
• Caution is advised for clinicians when considering PNCSCLD for preterm infants due to potential risks.