Retrospective Review of Prednisolone Use in Late Pre-term and Term Infants With Persistent Oxygen Requirements

The primary objective of this study was to evaluate the number of late pre-term and term neonates who were able to wean off oxygen after receiving short-course prednisolone therapy.

A retrospective review of prednisolone treatment in oxygen-dependent infants was performed on infants admitted to the neonatal intensive care unit (NICU) at Northwest Texas Hospital, Amarillo, Texas, and received oral prednisolone therapy between January 1, 2021, through January 2023. Patients included were born ≥ 34 weeks gestation and received prednisolone therapy for oxygen weaning. Data collection comprised of maternal and infant medical conditions, medications, oxygen requirements, chest x-ray findings, and length of stay. Prednisolone dosing, duration, and reported adverse effects were collected. Descriptive statistics such as mean and median were used to describe patient characteristics and outcomes.

Thirteen of the 26 infants admitted met the inclusion criteria. Seven (53.8%) were successfully weaned to room air; of these, 5 were weaned to room air by the sixth dose of prednisolone. Neonates with meconium-stained amniotic fluid had an 75% success rate (3 out of 4), and those with suspected/diagnosed transient tachypnea of the newborn (TTN) had 57.1% success (4 out of 7 infants).

Prednisolone therapy shows promising efficacy in weaning late pre-term and term infants off oxygen. Future randomized controlled trials are needed to determine the role and optimal prednisolone regimen.