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Factors associated with short-term response after systemic corticosteroid treatment in invasively ventilated preterm

Gyeong Eun Yeom1, Seung Han Shin2, Han-Suk Kim3

  • 1Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea.

BMC Pediatrics
|June 29, 2026
PubMed

Insights

Pulmonary hypertension and patent ductus arteriosus predict poor response to corticosteroid therapy in preterm infants with bronchopulmonary dysplasia. Early respiratory severity score changes can help identify non-responders.

Area of Science:

  • Neonatal medicine
  • Pediatric pulmonology
  • Critical care medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease in preterm infants.
  • Systemic corticosteroid (CS) therapy is used to treat BPD, but its efficacy varies.
  • Pulmonary hypertension (PH) and patent ductus arteriosus (PDA) are common complications in BPD.

Purpose of the Study:

  • To evaluate factors influencing short-term efficacy of systemic CS therapy in preterm infants with BPD.
  • To identify predictors of treatment response, focusing on PH and hemodynamically significant PDA (hsPDA).

Main Methods:

  • Retrospective review of preterm infants (<32 weeks gestation or <1500g) receiving systemic CS for BPD.
  • Responders defined by extubation within 14 days and/or ≥60% reduction in respiratory severity score (RSS).
  • Multivariate analysis to identify predictors of non-response.

Main Results:

  • Of 62 infants, 32 were responders and 30 non-responders.
  • Non-responders had higher prevalence of PH (70.0% vs. 21.9%) and hsPDA (30.0% vs. 3.1%) at treatment initiation.
  • PH and hsPDA were significant predictors of non-response (aOR 6.66 and 12.54, respectively).

Conclusions:

  • Vascular phenotypes (PH, hsPDA) in BPD should be identified before CS therapy initiation.
  • Early changes in RSS (day 1-4) can improve prediction of treatment failure.
  • Optimizing patient selection and early identification of non-responders can improve treatment outcomes.
Abstract

Keywords:
Bronchopulmonary dysplasiaDexamethasonePulmonary hypertensionRespiratory Severity Score

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