Research article summary (published 18 Jul 2009):

Time-related changes in steroid use and bronchopulmonary dysplasia in preterm infants.

Full Abstract

OBJECTIVE: To assess dexamethasone (DEX) and hydrocortisone (HC) use in premature infants over time and the association of steroid use with the incidence of bronchopulmonary dysplasia (BPD) at 36 weeks' postmenstrual age. METHODS: We analyzed data from the Pediatrix database for neonates of 23 to 32 weeks' gestation managed during 1997-2006 (N = 77520). We compared the use of DEX, HC and BPD (defined by oxygen use at 36 weeks' postmenstrual age) according to year and estimated gestational age. Mantel-Haenszel chi(2) was used to compare the trends in steroid use and BPD rates according to year. RESULTS: There were no differences by year in the proportion of births at each gestation or in early or late neonatal death. DEX use decreased from a peak of 25.0% in 1998 to 6.8% in 2006, but HC use increased from 1.1% in 1997 to a peak of 6.5% in 2006. The median age at initiation of DEX use increased >2 weeks from 1997 to 2006. BPD rates increased from 19% in 1997 to 25% by 2006. Rates for severe BPD (defined by positive pressure support) also increased significantly over time. Between 23 and 28 weeks, there was a significant increase in BPD rates associated with the decrease in DEX over time. CONCLUSIONS: Steroid use and preference have changed significantly over the past decade. Decreased use of DEX was associated with increased rates of BPD, any or severe, among very preterm infants. Well-designed, randomized, noncrossover trials with long-term outcome analysis of high-risk infants are needed.

Author information

Author/s: Yoder, Bradley A (BA); Harrison, Megan (M); Clark, Reese H (RH);

Affiliation: aDepartment of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah 84158-1289, USA. bradley.yoder(-atsign-)hsc.utah.edu

Journal and publication information

Publication Type: Journal Article

Journal: Pediatrics (Pediatrics), published in United States. (Language: eng)

Reference: 2009-Aug; vol 124 (issue 2) : pp 673-9

Dates: Created 2009/08/04; Completed 2009/08/13;

PMID: 19620192, status: MEDLINE (last retrieved date: 8/21/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MeSH Headings (categories) shown below.

Anti-Inflammatory Agents - administration & dosage Bronchopulmonary Dysplasia - diagnosis; drug therapy; epidemiology Cross-Sectional Studies Dexamethasone - administration & dosage Dose-Response Relationship, Drug Drug Utilization - trends Female Humans

Hydrocortisone - administration & dosage Infant, Extremely Low Birth Weight Infant, Newborn Infant, Very Low Birth Weight Intensive Care, Neonatal - trends Male Retrospective Studies Statistics as Topic

Note: Bold headings indicate primary MeSH headings or qualifiers.

Associated Chemicals: Anti-Inflammatory Agents (0) ; Dexamethasone (50-02-2) ; Hydrocortisone (50-23-7)

Related articles

These are the most related articles currently in our database:

• Inhaled versus systemic steroids in chronic oxygen dependency of preterm infants. 30 Dec 1996
• Total steroid dose given to ventilated newborn infants with chronic lung disease. 30 Dec 2006
• [Effect of corticosteroids on lung function and the clinical course of bronchopulmonary dysplasia in premature infants with a birth weight below 1,500 g] 30 Aug 1994
• Finding the optimal postnatal dexamethasone regimen for preterm infants at risk of bronchopulmonary dysplasia: a systematic review of placebo-controlled trials. 30 Dec 2008
• Changes in serum leptin concentration after corticosteroid treatment in preterm infants. 30 Dec 2001
• Effect of prolonged dexamethasone on oxygen-dependency in infants with chronic lung disease. 30 Dec 1998
• Maternal glucocorticoid therapy and reduced risk of bronchopulmonary dysplasia. 30 Aug 1990
• Do cortisol concentrations predict short-term outcomes in extremely low birth weight infants? 29 Sep 2008
• Early versus late dexamethasone treatment in preterm infants at risk for chronic lung disease: a randomized pilot study. 30 Mar 1999
• Leucine kinetics during simultaneously administered insulin and dexamethasone in preterm infants with severe lung disease. 27 Feb 2001

See 100+ related articles.

Related Article Map

Legend: - FREE Full text Article. - Abstract only. - Title only. More help.

See a larger map of 100+ related articles.