4.6 Review

Late (≥ 7 days) inhaled corticosteroids to reduce bronchopulmonary dysplasia in preterm infants

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Review Medicine, General & Internal

Early (< 7 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants

Lex W. Doyle et al.

Summary: Early systemic postnatal corticosteroid treatment can prevent bronchopulmonary dysplasia (BPD) and the combined outcome of mortality or BPD, but it may increase risks of gastrointestinal perforation, cerebral palsy, and the combined outcome of mortality or cerebral palsy. Most beneficial and harmful effects are related to early treatment with dexamethasone rather than hydrocortisone, although hydrocortisone may help prevent mortality. Long-term follow-up into late childhood is crucial for assessing the impact of early corticosteroid treatment on higher-order neurological functions. Further research on early corticosteroids, especially hydrocortisone, should prioritize longer-term survival free of neurodevelopmental disability as the primary outcome.

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