Follow-up of Preterm Infants Treated With Dexamethasone for Chronic Lung Disease
T. Michael O'Shea, MD, MPH;
Jamnadas M. Kothadia, MD;
Kurt L. Klinepeter, MD;
Donald J. Goldstein, PhD;
Barbara Jackson, RN, BSN;
Robert G. Dillard, MD
Am J Dis Child. 1993;147(6):658-661.
Abstract
• 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.
(AJDC. 1993;147:658-661)
Author Affiliations
From the Department of Pediatrics, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC.
Footnotes
Accepted for publication December 1, 1992.
Reprint requests to Medical Center Boulevard, Winston-Salem, NC 27157 (Dr O'Shea).
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