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. 2022 Jan;42(1):65-71.
doi: 10.1038/s41372-021-01251-y. Epub 2021 Nov 1.

Presumed adrenal insufficiency in neonates treated with corticosteroids for the prevention of bronchopulmonary dysplasia

Justin B Josephsen  1 , Brianna M Hemmann  2 , Connie D Anderson  3 , Brett M Hemmann  4 , Paula M Buchanan  5 , Howard L Williams  6 , Lisa M Lubsch  6   7 , Noah H Hillman  3
Affiliations

Presumed adrenal insufficiency in neonates treated with corticosteroids for the prevention of bronchopulmonary dysplasia

Justin B Josephsen et al. J Perinatol. 2022 Jan.

Abstract

Objective: To determine if extremely preterm (EPT) neonates receiving dexamethasone for the prevention of BPD have a higher incidence of presumed adrenal insufficiency (PAI).

Study design: Retrospective cohort study of neonates <28 weeks gestation examining PAI after dexamethasone use and PAI after intratracheal budesonide with surfactant administration.

Result: Of 332 neonates, 38% received dexamethasone. The incidence of PAI was higher in neonates who had received dexamethasone (20.8% vs 2.9%, p < 0.001). However, for intubated babies receiving surfactant, dexamethasone was not independently associated with increased PAI after adjusting for gestational age, birthweight, and race (aOR 2.92, 95% CI: 0.79-10.85). Dexamethasone was independently associated with increased PAI in infants previously receiving budesonide/surfactant treatment (aOR 5.38, 95% CI: 1.38-20.90).

Conclusion: The use of dexamethasone alone was not associated with increased PAI, when adjusted for prematurity-related factors. The combination of budesonide with dexamethasone was significantly associated with increased PAI.

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References

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