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Postnatal Steroids in Preterm Infants: A Narrative Review Series-Part 3: Impacts on Growth, Neurodevelopment &
Phoenix Plessas-Azurduy1, Jarred Garfinkle2, Marc Beltempo2
1Division of Clinical & Translational Research, Faculty of Medicine and Health Sciences, Montreal Children's Hospital, McGill University, Montreal, QC H3A 0G4, Canada.
Postnatal corticosteroids improve preterm infant breathing but may impact growth and brain development. A comprehensive approach is needed to balance these effects for optimal infant outcomes.
Area of Science:
- Neonatal Medicine
- Pediatric Pharmacology
Background:
- Postnatal corticosteroids (CS) are used to improve respiratory outcomes in preterm infants.
- Long-term effects of CS on infant growth and neurodevelopment require further investigation.
Purpose of the Study:
- To examine the systemic consequences of postnatal corticosteroids.
- To understand the interplay between CS, growth, hypoxia, and neurodevelopmental vulnerability.
Main Methods:
- This review builds on physiologic principles.
- It examines systemic corticosteroid consequences through a narrative review approach.
Main Results:
- Exploration of the relationship between growth restriction, hypoxia, and neurodevelopmental vulnerability.
- Discussion of findings related to brain imaging, metabolic disruptions, and hypothalamic-pituitary-adrenal (HPA) axis suppression.
Conclusions:
- Advocates for a holistic, physiology-informed approach to care for preterm infants.
- Emphasizes integrating nutritional vulnerability with cardiorespiratory status to optimize outcomes.
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