Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul 19;12(7):e0181176.
doi: 10.1371/journal.pone.0181176. eCollection 2017.

Postnatal dexamethasone, respiratory and neurodevelopmental outcomes at two years in babies born extremely preterm

Gordon Qin  1   2 , Jessica W Lo  1   3 , Neil Marlow  4 , Sandy A Calvert  5 , Anne Greenough  3   6 , Janet L Peacock  1
Affiliations

Postnatal dexamethasone, respiratory and neurodevelopmental outcomes at two years in babies born extremely preterm

Gordon Qin et al. PLoS One. .

Abstract

Importance: Postnatal dexamethasone is associated with reduction in bronchopulmonary dysplasia. There remains, however, concern that its short-term benefits are accompanied by long-term adverse effects e.g. poorer neurodevelopmental outcomes.

Objective: Our aim was to determine the effects of administration of postnatal dexamethasone on respiratory and neurodevelopmental outcome at two years of age after adjusting for neonatal and infant risk factors.

Materials and methods: The study included 412 infants born at 23-28 weeks of gestation, 29% had received postnatal dexamethasone. Two outcomes were examined, respiratory hospital admissions in the past 12 months and neurodevelopmental impairment. Logistic regression, adjusted for sex, birthweight z-score, gestation, maternal smoking, oxygen dependency at 36 weeks, airleak, patent ductus arteriosus, pulmonary haemorrhage, major ultrasound abnormality, mode of ventilation and age at assessment, was undertaken.

Results: After adjustment, postnatal dexamethasone was associated with significantly increased proportions of both respiratory hospital readmission: (0.35 vs 0.15, difference = 0.20; 95% CI: 0.08, 0.31) and neurodevelopmental impairment (0.59 vs 0.45, difference = 0.14; 95% CI: 0.02, 0.26).

Conclusions: Postnatal dexamethasone use in extremely preterm infants is associated with increased risks of respiratory hospital admissions and neurodevelopmental impairment. These associations were not explained by excess neonatal morbidities.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flow chart.
See this image and copyright information in PMC

References

    1. Doyle LW, Ehrenkranz RA, Halliday HL (2014) Early (< 8 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants (Review). Cochrane Database of Systematic Reviews 5:CD001146. - PubMed
    1. Doyle LW, Ehrenkranz RA, Halliday HL (2014) Late (> 7 days) Postnatal corticosteroids for chronic lung disease in preterm infants. Cochrane Database of Systematic Reviews 5:CD001145. - PubMed
    1. Yeh TF, Lin YJ, Lin HC, Huany CC, Hsieh WS, Lin CH, Cheng HT (2004) Outcomes at school age after postnatal dexamethasone therapy for lung disease of prematurity. N Engl J Med 350:1304–1313. doi: 10.1056/NEJMoa032089 - DOI - PubMed
    1. Vyas J, Kotecha S (1997) Effects of antenatal and postnatal corticosteroids on the preterm lung. Arch Dis Child 77:F147–F150. - PMC - PubMed
    1. Johnson AH, Peacock JL, Greenough A, Marlow N, Limb ES, Marston L et al.; United Kingdom Oscillation Study Group (2002) High-frequency oscillatory ventilation for the prevention of chronic lung disease of prematurity. N Engl J Med 347:633–642. doi: 10.1056/NEJMoa020432 - DOI - PubMed

MeSH terms