2-054 | Additional Comments | Previous Article | Next Article | List of Articles | Submit Comments | Index | FSN Home Page
Conference Highlights from Hot Topics in Neonatology Washington, DC; Dec 9-11, 2001
Postnatal Steroids Session, m
oderated by Alan, Jobe MDThe Great Steroid Dilemma: Short-term Benefits, Uncertain Risks. Michael O’Shea, Wake Forest University.
Dr. O’Shea reported the neuro-developmental follow-up results at 5 years of age of 74 ventilator-dependent premature infants (BW < 1500gm, age 15-25 days) who were randomized to receive dexamethasone or placebo for treatment of their lung disease. There was no difference between groups at 5 years of age in intelligence, pre-academic skills, pulmonary function, growth or blood pressure. Cerebral palsy was found 3.4 times more frequently in the group that received postnatal dexamethasone treatment (26% vas 9% in the placebo group, p = 0.04). In light of this finding, Dr O’Shea recommended reserving post-natal steroids for the "rare case of an infant in the severest stages of lung injury who appears to have a low chance of survival".
Comment. These data reflect long-term outcomes when using "industrial strength" doses of dexamethasone for long duration (0.5 mg/kg/d x 3d, then tapered doses over 42 days). To date, we have no good long-term outcome data looking at using lower doses, shorter courses, or different corticosteroid preparations. We desperately need a large randomized, controlled trial to explore these options.
Additional Comments: You may add your own comments to the discussion of this topic by selecting : Submit Comments.