Timing of postnatal steroids for bronchopulmonary dysplasia: association with pulmonary and neurodevelopmental outcomes
- 4 February 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Perinatology
- Vol. 40 (4), 616-627
- https://doi.org/10.1038/s41372-020-0594-4
Abstract
Objective To determine the associations between age at first postnatal corticosteroids (PNS) exposure and risk for severe bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI). Study design Cohort study of 951 infants born <27 weeks gestational age at NICHD Neonatal Research Network sites who received PNS between 8 days of life (DOL) and 36 weeks’ postmenstrual age was used to produce adjusted odds ratios (aOR). Results Compared with infants in the reference group (22–28 DOL-lowest rate), aOR for severe BPD was similar for children given PNS between DOL 8 and 49 but higher among infants treated at DOL 50–63 (aOR 1.77, 95% CI 1.03–3.06), and at DOL ≥64 (aOR 3.06, 95% CI 1.44–6.48). The aOR for NDI did not vary significantly by age of PNS exposure. Conclusion For infants at high risk of BPD, initial PNS should be considered prior to 50 DOL for the lowest associated odds of severe BPD.Keywords
This publication has 34 references indexed in Scilit:
- Hydrocortisone Treatment for Bronchopulmonary Dysplasia and Brain Volumes in Preterm InfantsThe Journal of Pediatrics, 2013
- Postnatal Corticosteroids to Prevent or Treat Bronchopulmonary DysplasiaPediatrics, 2010
- Impact of Postnatal Corticosteroid Use on Neurodevelopment at 18 to 22 Months' Adjusted Age: Effects of Dose, Timing, and Risk of Bronchopulmonary Dysplasia in Extremely Low Birth Weight InfantsPediatrics, 2009
- Early (< 8 days) postnatal corticosteroids for preventing chronic lung disease in preterm infantsPublished by Wiley ,2009
- Validation of the National Institutes of Health Consensus Definition of Bronchopulmonary DysplasiaPediatrics, 2005
- Extremely Low Birthweight Neonates with Protracted Ventilation: Mortality and 18-Month Neurodevelopmental OutcomesThe Journal of Pediatrics, 2005
- Impact of Postnatal Systemic Corticosteroids on Mortality and Cerebral Palsy in Preterm Infants: Effect Modification by Risk for Chronic Lung DiseasePediatrics, 2005
- Outcomes at School Age after Postnatal Dexamethasone Therapy for Lung Disease of PrematurityNew England Journal of Medicine, 2004
- A Multicenter Trial of Two Dexamethasone Regimens in Ventilator-Dependent Premature InfantsNew England Journal of Medicine, 1998
- A united states national reference for fetal growthObstetrics & Gynecology, 1996