Controversies in the use of postnatal steroids

Abstract

This review evaluates and compares, by using the best available medical evidence, the risks and benefits of postnatal steroid use in very low birth weight infants. Systemic postnatal steroids are effective at reducing the risk of chronic lung disease in ventilated very low birth weight infants; they appear to be most effective when administered to ventilator-dependent infants at 7 to 14 days of age. The beneficial effects are accompanied by an increase in the risk of long-term neurologic sequelae in addition to a number of short-term complications. Whether these risks are justified is largely dependent on the relative value that a parent or caregiver would place on chronic lung disease as compared to the adverse neurologic sequelae.