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

Adithya Shastry1,2, Danish Ahmad2, Alice Richardson3

  • 1Department of Neonatology, The Australian National University Medical School, Centenary Hospital for Women and Children, Canberra Hospital, PO Box 11, Garran, Canberra, ACT, Woden ACT 2606, Australia.

World Journal of Pediatrics : WJP
|June 27, 2025
PubMed

Insights

Postnatal corticosteroid use for chronic lung disease (PNCSCLD) in preterm infants increased over eleven years and was linked to higher rates of moderate to severe functional disability (MSFD). Clinicians should use PNCSCLD cautiously.

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.
Abstract

Keywords:
NeurosensoryOutcomePretermSteroid

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