Postnatal steroid treatment increases neuro-developmental impairment

Postnatal administration of corticosteroids for treatment and prevention of chronic lung disease such as bronchopulmonary dysplasia is a widespread practice and to date there have been no adequate analyses of long-term adverse effects.

By | March 16, 2001

Postnatal administration of corticosteroids for treatment and prevention of chronic lung disease such as bronchopulmonary dysplasia is a widespread practice and to date there have been no adequate analyses of long-term adverse effects. According to a meta-analysis just published in BMC Pediatrics, postnatal steroid treatment is associated with dramatic increases in neuro-developmental impairment and steroid use to prevent or treat bronchopulmonary dysplasia should be abandoned (BMC Pediatrics 2001, 1:1).

Keith Barrington from Royal Victoria Hospital, Montreal, Quebec, did a systematic review of the literature and found eight randomized controlled trials with at least one year neuro-developmental follow-up. Analysis of the combined data from these trials showed a high relative risk for the development of cerebral palsy after steroid treatment (2.86; 95% CI 1.95, 4.19) and also for the development of neuro-developmental disability (1.66; 95% CI 1.26, 2.19).

The author, who was among the first to suggest postnatal use of corticosteroids for chronic lung disease (J Perinatol 1985, 5:26-32), says that abandoning all use of postnatal steroids for this indication is urgently needed and "would not increase mortality, prolong hospitalisation, or increase the numbers of infants receiving home oxygen therapy."

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