Am J Perinatol 2005; 22(2): 77-81
DOI: 10.1055/s-2005-837274
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Effect of Decreased Use of Postnatal Corticosteroids on Morbidity in Extremely Low Birthweight Infants

Praveen Kumar1
  • 1Department of Pediatrics, Northwestern Memorial Hospital and Children's Memorial Hospital, Northwestern University, Chicago, Illinois
Further Information

Publication History

Publication Date:
04 February 2005 (online)

ABSTRACT

The objective of this study was to evaluate the effect of decrease in use of postnatal corticosteroids on duration of assisted ventilation and hospital stay of extremely low birthweight infants. All infants born between January 1, 1999, and December 31, 2000, and with birthweight ≤ 1000 g were included if they survived to be discharged home. Postnatal corticosteroids use in these infants decreased from 44% in 1999 (group 1) to 13% in 2000 (group 2; p = 0.002). The mean duration of assisted ventilation was similar in the two groups (20.6 ± 19.7 versus 24.5 ± 22.2 days; p = 0.4), as was the mean duration of hospital stay (82.2 ± 23.5 versus 85.1 ± 30.5 days; p = 0.6). The incidence of late-onset bacterial sepsis was significantly lower among group 2 infants (17% versus 40%; p = 0.02).

REFERENCES

  • 1 Horbar J D, Badger G J, Carpenter J H et al.. Trends in mortality and morbidity for very low birth weight infants, 1991-1999.  Pediatrics. 2002;  110 143-151
  • 2 Lee S K, McMillan D D, Ohlsson A et al.. Variations in practice and outcomes in the Canadian NICU Network: 1996-1997.  Pediatrics. 2000;  106 1070-1079
  • 3 Lemons J A, Bauer C R, Oh W et al.. Very low birth weight outcomes of the National Institutes of Child Health and Human Development Neonatal Research Network, January 1995 through December 1996.  Pediatrics. 2001;  107 E1
  • 4 Barrington K J, Finer N N. Treatment of bronchopulmonary dysplasia.  Clin Perinatol. 1998;  25 177-202
  • 5 Mammel M C, Green T P, Johnson D E et al.. Controlled trial of dexamethasone therapy in infants with bronchopulmonary dysplasia.  Lancet. 1983;  1(8338) 1356-1358
  • 6 Avery G B, Fletcher A B, Kaplan M et al.. Controlled trial of dexamethasone in respirator-dependent infants with bronchopulmonary dysplasia.  Pediatrics. 1985;  75 106-111
  • 7   . Collaborative Dexamethasone Trial Group .Dexamethasone therapy in neonatal chronic lung disease: an international placebo-controlled trial. Pediatrics 1991 88: 421-427
  • 8 Cummings J J, D'Eugenio D B, Gross S J. A controlled trial of dexamethasone in preterm infants at high risk bronchopulmonary dysplasia.  N Engl J Med. 1989;  320 1505-1510
  • 9 Soll R F. for the Vermont Oxford Network Steroid Study Group .Early postnatal dexamethasone therapy for the prevention of chronic lung disease. Pediatrics 2001 108: 741-748
  • 10 Banks B A. Postnatal dexamethasone for bronchopulmonary dysplasia: a systematic review and meta-analysis of 20 years of clinical trials.  NeoReviews. 2002;  3 e24-e34
  • 11 Doyle L, Davis P. Postnatal corticosteroids in preterm infants: systematic review of effects on mortality and motor function.  J Paediatr Child Health. 2000;  36 101-107
  • 12 American Academy of Pediatrics and Canadian Pediatric Society .Postnatal corticosteroids to treat or prevent chronic lung disease in preterm infants. Pediatrics 2002 109: 330-338
  • 13 Halliday H L, Ehrenkranz R A. Early postnatal (< 96 hours) corticosteroids for preventing chronic lung disease in preterm infants (Cochrane Review).  Cochrane Database Syst Rev. 2001;  1 CD001146
  • 14 Halliday H L, Ehrenkranz R A. Moderately early (7-14 days) postnatal cortcosteroids for preventing chronic lung disease in preterm infants (Cohrane Review).  Cochrane Database Syst Rev. 2001;  1 CD001144
  • 15 Halliday H L, Ehrenkranz R A. Delayed (> 3 weeks) postnatal corticosteroids for chronic lung disease in preterm infants (Cochrane Review).  Cochrane Database Syst Rev. 2001;  2 CD001145
  • 16 Stark A R, Carlo W A, Tyson J E et al.. Adverse effects of early dexamethasone treatment in extremely-low-birth-weight infants.  N Engl J Med. 2001;  344 95-101
  • 17 Barrington K J. The adverse neuro-developmental effects of postnatal steroids in the preterm infant: a systematic review of RCTs.  BMC Pediatr. 2001;  1 1-14
  • 18 Stoll B J, Hansen N, Fanaroff A A et al.. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD neonatal research network.  Pediatrics. 2002;  110 285-291
  • 19 Makhoul I R, Sujov P, Smolkin T et al.. Epidemiological, clinical, and microbiological characteristics of late-onset sepsis among very low birth weight infants in Israel: a national survey.  Pediatrics. 2002;  109 34-39

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