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Conference Highlights from Hot Topics in Neonatology Washington, DC; Dec 9-11, 2001
Postnatal Steroids Session, m
oderated by Alan, Jobe MDCorticosteroids for the Treatment and Prevention of Chronic Lung Disease. Roger F. Soll MD, University of Vermont.
Dr. Soll presented the results of a meta-analysis of randomized controlled trials of postnatal steroid therapy for treatment of prevention of chronic lung disease (CLD) in premature infants. Postnatal steroids were shown to be effective in reducing the risk of CLD and of increasing the chance of survival without CLD regardless of whether the steroids were started early (<96 hrs), moderately early (1-2 weeks) or late (>3 weeks). Early steroid use was associated with an increased risk of neurodevelopmental problems including cerebral palsy, developmental delays, abnormal neurologic exams, Bayley PDI <70, and periventricular leukomalacia. In light of these findings, Dr. Soll recommended that steroids should be given only to infants at greatest risk of serious lung complications, administered at the lowest dose and the least cumulative dose feasible. He added that future trials of post-natal steroids must include appropriate follow up testing.
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