Abstract
Objective: To evaluate the benefits and the medium-term side effects of methylprednisolone in very preterm infants at risk of chronic lung disease.
Study design: Forty-five consecutive preterm infants (<30 weeks' gestation) at risk of chronic lung disease were treated at a mean postnatal age of 16 days with a tapering course of methylprednisolone. The outcome of treatment was assessed by comparison with 45 consecutive historical cases of infants treated with dexamethasone; the infants did not differ in baseline characteristics.
Results: There were no differences between groups in the rate of survivors without chronic lung disease. Infants treated with methylprednisolone had a higher rate of body weight gain during the treatment period (median 120 g, range 0 to 190, vs. 70 g, range –110 to 210, P=0.01) and between birth and the age of 40 weeks (median 1660 g, range 1170–2520, vs. 1580 g, range 1040 to 2120, P=0.02). The incidence of both glucose intolerance requiring insulin (0% vs. 18%, P=0.006) and cystic periventricular leukomalacia (2% vs. 18%, P=0.03) was lower among methylprednisolone-treated infants.
Conclusion: Our observations confirm methylprednisolone to be as effective as dexamethasone and to have fewer side effects. A randomized control trial is needed to further study the efficacy and safety of methylprednisolone in very premature infants at risk of chronic lung disease.
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Final revision received: 19 May 2000
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André, P., Thébaud, B., Odièvre, M. et al. Methylprednisolone, an alternative to dexamethasone in very premature infants at risk of chronic lung disease. Intensive Care Med 26, 1496–1500 (2000). https://doi.org/10.1007/s001340000588
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DOI: https://doi.org/10.1007/s001340000588