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Updated: Feb 25, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatologists' practices in screening and managing corticosteroid-induced adrenal insufficiency in the NICU- a
Sean Christopher Watson1, Parvesh Mohan Garg1, Cathrine Constantacos2
1Wake Forest University School of Medicine, Department of Neonatology, Winston-Salem, NC, USA.
Objective:
To examine the variability in neonatologists' screening and management practices of corticosteroid-induced adrenal insufficiency (adrenal suppression; AS) in the NICU.
Study Design:
A cross-sectional survey was disseminated nationally via REDCap® to 160 neonatologists who serve as members of Children's Hospitals Neonatal Consortium. Descriptive statistics were used to capture variability in AS screening modalities, diagnostic tools, management approaches, and discharge planning.
Result:
Of the 82 respondents, only 56.1% screen infants for AS following prolonged systemic corticosteroid exposure, 46.3% after 2-4 weeks, 59.8% utilizing ACTH stimulation testing. Only 2.4% screen after prolonged high dose inhaled corticosteroids, reflecting uncertainty regarding their suppressive potential. Additionally, only 30.5% provide structured caregiver AS education at discharge.
Conclusion:
Variable nationwide screening and management of adrenal suppression in the NICU underscores uncertainty and inconsistency in practice, revealing the need for clinical guidelines to optimize care.
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