Follow-up of preterm infants treated with dexamethasone for chronic lung disease

T. M. O'Shea, J. M. Kothadia, K. L. Klinepeter, D. J. Goldstein, B. Jackson and R. G. Dillard
Department of Pediatrics, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC.

OBJECTIVE--To study the outcome of prolonged treatment with dexamethasone sodium phosphate in preterm infants who depend on assisted ventilation. DESIGN--Longitudinal follow-up using historic controls. SETTING--Regional intensive care nursery. PARTICIPANTS--Sixty-one very-low-birth-weight infants treated with a 42-day course of dexamethasone and 61 historic controls matched for birth weight, gestational age, race, and sex. All 122 subjects required assisted ventilation for at least 15 days. INTERVENTION--Infants were given dexamethasone sodium phosphate at a dose of 0.5 mg/kg per day. The dose was then tapered over 42 days. MEASUREMENTS/MAIN RESULTS--Infants treated with dexamethasone received assisted ventilation for a median of 33 days; controls, a median of 47 days (P < .05). One hundred infants survived; 94 were examined at age 1 year. The two groups were similar with respect to the proportions hospitalized for respiratory infection in the first year of life and the proportions with weight, length, and head circumference below the fifth percentile. Rates of cerebral palsy were also similar between the two groups, as were median Bayley Mental and Psychomotor developmental index scores. CONCLUSIONS--Dexamethasone treatment was associated with fewer days of assisted ventilation, but not with improved outcome at age 1 year. More assessment should be made of dexamethasone's effect on long-term outcome before dexamethasone becomes widely used in preterm infants who depend on assisted ventilation.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Changes in the Use of Postnatal Steroids for Bronchopulmonary Dysplasia in 3 Large Neonatal Networks
Walsh et al.
Pediatrics 2006;118:e1328-e1335.
ABSTRACT | FULL TEXT  

Outcomes at School Age after Postnatal Dexamethasone Therapy for Lung Disease of Prematurity
Yeh et al.
NEJM 2004;350:1304-1313.
ABSTRACT | FULL TEXT  

A three year follow up of preterm infants after moderately early treatment with dexamethasone
Romagnoli et al.
Arch. Dis. Child. Fetal Neonatal Ed. 2002;87:F55-58.
ABSTRACT | FULL TEXT  

Dexamethasone Therapy Increases Infection in Very Low Birth Weight Infants
Stoll et al.
Pediatrics 1999;104:63e-63.
ABSTRACT | FULL TEXT  

Randomized Placebo-controlled Trial of a 42-Day Tapering Course of Dexamethasone to Reduce the Duration of Ventilator Dependency in Very Low Birth Weight Infants: Outcome of Study Participants at 1-Year Adjusted Age
O'Shea et al.
Pediatrics 1999;104:15-21.
ABSTRACT | FULL TEXT  

Randomised controlled study of early use of inhaled corticosteroid in preterm infants with respiratory distress syndrome
Fok et al.
Arch. Dis. Child. Fetal Neonatal Ed. 1999;80:203F-208.
ABSTRACT | FULL TEXT  

Randomized Placebo-controlled Trial of a 42-Day Tapering Course of Dexamethasone to Reduce the Duration of Ventilator Dependency in Very Low Birth Weight Infants
Kothadia et al.
Pediatrics 1999;104:22-27.
ABSTRACT | FULL TEXT  

Early Dexamethasone Therapy in Preterm Infants: A Follow-up Study
Yeh et al.
Pediatrics 1998;101 :e7-e7.
ABSTRACT | FULL TEXT  

A Multicenter Trial of Two Dexamethasone Regimens in Ventilator-Dependent Premature Infants
Papile et al.
NEJM 1998;338:1112-1119.
ABSTRACT | FULL TEXT