Neonatal hydrocortisone treatment: neurodevelopmental outcome and MRI at school age in preterm-born children.

Abstract

OBJECTIVE:

To investigate neurodevelopment at school age in preterm infants treated with hydrocortisone for bronchopulmonary dysplasia (BPD) in the neonatal period.

STUDY DESIGN:

Preterm infants (n = 226; gestational age < or = 32 weeks and/or body weight < or = 1500 grams) performed subtests of the Wechsler Intelligence Scale for Children-Revised, the Visual Motor Integration test, a 15-Word Memory Test and the Movement Assessment Battery for Children at school age. Conventional MRI of the brain was obtained. Sixty-two children who received hydrocortisone for BPD (starting dose, 5 mg/kg/day; median duration, 27.5 days) were compared with 164 nontreated neonates.

RESULTS:

Hydrocortisone-treated infants were younger, lighter, and sicker than their non-steroid-treated counterparts. Adjustments for gestational age, body weight, sex, mechanical ventilation, and small for gestational age were made. Adjusted mean Intelligence Quotient, Visual Motor Integration test, and memory test results were the same in the hydrocortisone-treated group and the non-steroid-treated group (99 versus 101, P = .62; 97 versus 99, P = .49, 7.9 versus 7.5, P = .42, respectively). Motor function and incidence of cerebral palsy in both groups was not different (11% versus 7%, P = .97). Occurrence of brain lesions on MRI was similar for the two groups.

CONCLUSIONS:

Neonatal hydrocortisone treatment for BPD had no long-term effects on neurodevelopment.

• Authors: Karin J Rademaker, Cuno S P M Uiterwaal, Floris Groenendaal, Monica M A T Uniken Venema, Frank van Bel, Frederik J Beek, Ingrid C van Haastert, Diederick E Grobbee, Linda S de Vries
• Journal: The Journal of pediatrics (J Pediatr) Vol. 150 Issue 4 Pg. 351-7 (Apr 2007) ISSN: 1097-6833 [Electronic] United States
• PMID: 17382109 (Publication Type: Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Hydrocortisone

Topics

• Anti-Inflammatory Agents (therapeutic use)
• Brain Diseases (diagnosis)
• Bronchopulmonary Dysplasia (drug therapy)
• Child
• Child Development (drug effects)
• Cognition (drug effects)
• Female
• Humans
• Hydrocortisone (therapeutic use)
• Infant, Newborn
• Infant, Premature
• Magnetic Resonance Imaging
• Male
• Motor Skills (drug effects)
• Nervous System (drug effects)
• Time