Low-dose steroids are brain-safe for preterm bubs
Low doses of steroids given to preterm infants (born at younger than 28 weeks old) to help their survival are not linked to any harmful effects on their brain development at two years of age, according to a French study.
The study, published in JAMA, looked at data of over 500 newborns, where half were given low-dose hydrocortisone and half were given placebos. At two years of age there were no significant difference in terms of brain development issues between the two groups.
Early low-dose hydrocortisone treatment in very preterm infants has been reported to improve survival without bronchopulmonary dysplasia (a form of chronic lung disease), but its safety with regard to neurodevelopment has been an answered question.
Olivier Baud, MD, PhD, of Robert Debre Children’s Hospital, Paris, and colleagues analysed data from the PREMILOC trial, in which infants born between 24 0/7 weeks and 27 6/7 weeks of gestation and before 24 hours of postnatal age were randomly assigned to receive either placebo or low-dose hydrocortisone injection.
Of neonates screened, 523 were assigned to hydrocortisone (n = 256) or placebo (n = 267) and 406 survived to 2 years of age.
At 22 months of age a total of 379 patients (93%) were evaluated and researchers found no statistically significant difference in patients without neurodevelopmental impairment (73% in the hydrocortisone group vs 70% in the placebo group), with mild neurodevelopmental impairment (20% in the hydrocortisone group vs 18% in the placebo group), or with moderate to severe neurodevelopmental impairment (7% in the hydrocortisone group vs 11% in the placebo group). The incidence of cerebral palsy or other major neurological impairments was not significantly different between groups.
“Further randomised studies are needed to provide definitive assessment of the neurodevelopmental safety of hydrocortisone in extremely preterm infants,” the authors wrote.
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