Decreased Use of Postnatal Corticosteroids in Extremely Preterm Infants without Increasing Chronic Lung Disease

Seth, R, Gray, P.H. and Tudehope, D.I. (2008) Decreased Use of Postnatal Corticosteroids in Extremely Preterm Infants without Increasing Chronic Lung Disease. Neonatology, 95 2: 172-178. doi:10.1159/000153102


Author Seth, R
Gray, P.H.
Tudehope, D.I.
Title Decreased Use of Postnatal Corticosteroids in Extremely Preterm Infants without Increasing Chronic Lung Disease
Journal name Neonatology   Check publisher's open access policy
ISSN 1661-7800
Publication date 2008-09-06
Year available 2008
Sub-type Article (original research)
DOI 10.1159/000153102
Volume 95
Issue 2
Start page 172
End page 178
Total pages 7
Editor Speer, C
Halliday, H
Place of publication Switzerland
Publisher S. Karger AG
Collection year 2009
Language eng
Subject C1
920501 Child Health
111401 Foetal Development and Medicine
Abstract Background: Postnatal corticosteroids are effective in preventing chronic lung disease in preterm infant. There are concerns that corticosteroid use may be associated with an increased risk of impaired neurodevelopment. Objective: To examine the effect of change in practice with the use of postnatal corticosteroids over an 8-year period in extremely preterm babies on the incidence of chronic lung disease (CLD) and cerebral palsy at 1 year of age. Methods: Babies of birth weight <1,000 g or gestational age <28 weeks admitted from 1997 to 2004 were included in this retrospective analysis. The study period was divided into two eras: group 1: 1997-2000, group 2: 2001-2004. Data were collected from the neonatal database, individual records and from the Growth and Development Unit. The outcome measure of CLD was defined as oxygen dependency at 36 weeks post-menstrual age. Data for postnatal corticosteroid usage were collected for the number of babies per year, and total dose. Results: 389 group 1 babies were compared to 368 group 2 babies. There was a significant decrease in the use of dexamethasone from 27% in group 1 to 13% in group 2 (p = 0.0001), and total dose - mg/kg (4.5 +/- 2.9 vs. 2.6 +/- 1.6, p = 0.0001). The incidence of CLD and need for home oxygen was similar between groups. The incidence of cerebral palsy reduced from 10.4% in group 1 to 6.6% in group 2, though this was not statistically significant (OR 0.63; 95% Cl 0.3, 1.2.). Conclusion: Decreased postnatal corticosteroid use had no impact on the incidence of CLD or need for home oxygen therapy. The trend towards a reduced rate of cerebral palsy requires further investigation. Copyright (c) 2008 S. Karger AG, Basel
Keyword Postnatal corticosteroids
LOW-BIRTH-WEIGHT
Q-Index Code C1
Q-Index Status Provisional Code

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Thu, 03 Sep 2009, 09:16:39 EST by Mr Andrew Martlew on behalf of Mater Clinical School