Original articleNeonatal Hydrocortisone Treatment: Neurodevelopmental Outcome and MRI at School Age in Preterm-born Children
Section snippets
Methods
The children studied are part of a cohort of consecutively admitted patients soon after birth over a period of 2 years to the neonatal intensive care unit (NICU) of the Wilhelmina Children’s Hospital, a tertiary referral center. All children, born between March 1, 1991, and March 1, 1993, with a gestational age (GA) ≤32 weeks (range, 25.0 to 33.0) and/or a birth weight (BW) ≤1500 grams, were subsequently enrolled in a long-term follow-up study. The original group consisted of 375 children.
Patient Characteristics
Mean GA of steroid-treated children was less and mean BW was lower compared with children who never received steroids (Table I). Treated children were also sicker, as shown by a significantly higher incidence of mechanical ventilation, need for surfactant and inotropes, and an increased incidence of patent ductus arteriosus (PDA). There was no difference in the proportion of mothers of steroid-exposed and non–steroid-exposed children who had received a complete course of antenatal betamethasone
Discussion
The findings of this cohort study of 226 preterm-born children followed up for 8 years do not demonstrate any unfavorable structural or functional effects of neonatal treatment with hydrocortisone on brain development at school age. To appreciate these results, some issues need to be addressed. We estimated the effects of treatment by using data obtained in routine care rather than conducting a randomized trial. Consequently, children who were treated had clinical indication for treatment.
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This study was supported by University Medical Center Utrecht (Zonproject).