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Steroids and bronchopulmonary dysplasia
Are postnatal steroids ever justified to treat severe bronchopulmonary dysplasia?
Baylor College of Medicine, Houston, Texas, USA
Correspondence to:
Eric C Eichenwald, Baylor College of Medicine, Houston, Texas, USA; eichenwa@bcm.ed
Accepted 12 March 2007
Current evidence does not favour use of corticosteroids as neurological side effects may outweigh the benefits of treatment, except perhaps in critically ill infants with respiratory failure
Keywords: bronchopulmonary dysplasia; corticosteroids; dexamethasone; prematurity; very low birthweight infant
| The first 150 words of the full text of this article appear below. |
Numerous trials have confirmed that prenatal glucocorticoid treatment of women threatening preterm delivery increases survival and reduces the occurrence of respiratory distress syndrome, intraventricular haemorrhage and necrotising enterocolitis in infants born before 32–34 weeks’ gestation.1 However, despite widespread use of prenatal steroids and administration of surfactant to treat or prevent respiratory distress syndrome, extremely preterm infants remain at high risk for the development of bronchopulmonary dysplasia (BPD). In two large databases in the USA and Canada, BPD, defined as receipt of supplemental oxygen at 36 weeks’ postmenstrual age, affected about a quarter of very low birthweight infants, approximately a third of infants weighing 750–1000 g and half of those who weighed less than 750 g at birth.2 3
The cause of BPD in susceptible infants is multifactorial. The immature lung is most vulnerable to disruption of alveolar development in the stage before alveolar formation begins (23–26 weeks’
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