Document Detail


Controlled trial of early dexamethasone treatment for the prevention of chronic lung disease in preterm infants: a 3-year follow-up.
MedLine Citation:
PMID:  12042579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: There is increasing concern in regard to the possible long-term adverse effects of postnatal dexamethasone treatment in preterm infants. The purpose of this study was to assess growth and neurodevelopmental outcome in preterm infants at high risk of chronic lung disease (CLD), treated with early (<96 hours) postnatal dexamethasone. DESIGN: Three-year follow-up data of physical growth and neurodevelopmental outcome of preterm infants enrolled in a controlled trial to study the effectiveness of early postnatal dexamethasone administration for the prevention of CLD were reviewed. The original trial included 25 treated neonates who received dexamethasone intravenously from the fourth day of life for 7 days (0.5 mg/kg/d for the first 3 days, 0.25 mg/kg/d the next 3 days, and 0.125 mg/kg/d on the seventh day), and 25 untreated neonates as controls. Forty-five surviving infants (22 untreated and 23 treated) completed the 3-year follow-up. RESULTS: At the end of follow-up, infants pertaining to both study groups had similar values for body weight, height, and head circumference, and a similar incidence of infants with anthropometrics data below the third percentile. Moreover, no differences were detected between the groups in regard to incidence of major cranial ultrasound abnormalities, cerebral palsy, major neurosensory impairment or IQ scores, and distribution. CONCLUSIONS: Early (<96 hours) postnatal dexamethasone administration at the doses employed in this study did not impair physical or neurodevelopmental outcome in preterm infants at high risk of CLD. However, the small sample size of our study was not tailored to look for long-term outcomes and our results are not in agreement with those of larger trials and systematic reviews. The real risks of postnatal dexamethasone administration could be definitely assessed only when more well-designed trials using long-term neurodevelopmental assessment as the primary outcome will be reported.
Authors:
Costantino Romagnoli; Enrico Zecca; Rita Luciano; Giulia Torrioli; Giuseppe Tortorolo
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Pediatrics     Volume:  109     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-03     Completed Date:  2002-07-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e85     Citation Subset:  AIM; IM    
Affiliation:
Division of Neonatology, Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy. cromagnoli@rm.unicatt.it
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents / administration & dosage,  pharmacology,  therapeutic use*
Child Development / drug effects*,  physiology*
Child, Preschool
Chronic Disease
Confidence Intervals
Developmental Disabilities / prevention & control
Dexamethasone / administration & dosage,  pharmacology,  therapeutic use*
Drug Administration Schedule
Follow-Up Studies
Humans
Infant
Infant, Newborn
Infant, Premature, Diseases / drug therapy*
Lung Diseases / prevention & control*
Odds Ratio
Outcome Assessment (Health Care)
Patient Readmission
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 50-02-2/Dexamethasone
Comments/Corrections
Comment In:
Pediatrics. 2002 Jun;109(6):1168-9   [PMID:  12042559 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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