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AAP Grand Rounds 3:6-7 (2000)
© 2000 American Academy of Pediatrics

NEUROLOGY

Postnatal Steroids and Neurodevelopmental Outcome in Low Birth Weight Infants

Source: O’Shea MT, Kothadia JM, et al. Randomized placebo controlled trial of a 42-day tapering course of dexamethasone to reduce the duration of ventilator dependency in very low birth weight: outcome of study participants at 1-year adjusted age. Pediatrics. 1999;104:15–21.

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This study from Winston-Salem, North Carolina, evaluated the neurodevelopmental outcome at one year of age of 118 ventilator-dependent, very low birth weight (VLBW, less than 1501g) infants treated with a 42-day tapering course of dexamethasone used to decrease the risk and severity of chronic lung disease. The study was randomized, double blinded, placebo-controlled in design involving infants who were not weaning from assisted ventilation at 15–25 days of age. Treatment (n=57) and placebo (n=61) groups had similar baseline characteristics. Five infants randomized to dexamethasone had a major intracranial abnormality detected by ultrasound prior to treatment while 5 more dexamethasone treated infants developed such abnormalities after randomization. In the placebo group, 4 infants were similarly affected prior to randomization while 1 developed this complication after randomization. Survival at 1 year adjusted age was 88% for the dexamethasone group and 74% for the placebo group (P=.066). Ninety-three of the 95 survivors underwent testing with Bayley Scales of Infant Development and Vineland Adaptive Behavioral Scales at 1 year corrected age. They also had . . . [Full Text of this Article]

Anju Gupta, MD, FAAP
Clinical Pediatrics, Division of Neonatology, Babies & Children’s Hospital, Columbia-Presbyterian Medical Center, NY