PEDIATRICS Vol. 116 No. 2 August 2005, pp. 379-384 (doi:10.1542/10.1542/peds.2004-1819)
Randomized, Controlled Trial of Dexamethasone in Neonatal Chronic Lung Disease: 13- to 17-Year Follow-up Study: II. Respiratory Status, Growth, and Blood Pressure
From the National Perinatal Epidemiology Unit, Oxford University, Oxford, United Kingdom
Objectives. To study the growth, health status, and respiratory outcomes at 13 to 17 years of infants enrolled in a double-blind, randomized, controlled trial of dexamethasone for the treatment of neonatal chronic lung disease.
Participants. A total of 287 infants who were chronically dependent on supplementary oxygen between 2 and 12 weeks of age were recruited from 31 centers in 6 countries to a double-blind, randomized, controlled trial of dexamethasone base (0.5 mg/kg per day for 1 week) or placebo, and survivors were evaluated at 3 years. Children from the 25 British and Irish centers were traced for reassessment at 13 to 17 years of age.
Outcome Measures. Respiratory symptoms, lung-function testing, height, weight, head circumference, blood pressure, health resource usage, and school absences.
Results. There was no significant difference in respiratory outcomes between the dexamethasone and placebo groups. Lung function was impaired but with no difference between the 2 groups. Growth was also impaired in both groups, with height z score of –0.7, weight z score of –0.4, and head circumference z score of –1.1. Systolic blood pressure was >95th percentile for age and height for 15% of children, but with no difference between the 2 groups. There was no difference in the numbers of hospital admissions for respiratory causes or other causes.
Conclusions. Despite a shorter duration of neonatal assisted ventilation, there is no evidence that dexamethasone use is associated with long-term improvement in lung function. Impaired growth and poor health status are long-term consequences of neonatal chronic lung disease, irrespective of exposure to neonatal dexamethasone.
Key Words: randomized • controlled trial • dexamethasone • neonatal • chronic lung disease • follow-up • respiratory • lung function • blood pressure • health status • growth
Abbreviations: CLD, chronic lung disease • FVC, forced vital capacity • FEV1, forced expiratory volume in 1 second • RR, relative risk • CI, confidence interval • GP, general practitioner
Accepted Nov 17, 2005.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  R. Karemaker, J. M. Karemaker, A. Kavelaars, M. Tersteeg-Kamperman, W. Baerts, S. Veen, J. F. Samsom, F. van Bel, and C. J. Heijnen Effects of Neonatal Dexamethasone Treatment on the Cardiovascular Stress Response of Children at School Age Pediatrics, November 1, 2008; 122(5): 978 - 987. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. B. de Vries, R. Karemaker, N. F. Mooy, J. L. M. Strengers, H. Kemperman, W. Baerts, S. Veen, G. H. A. Visser, C. J. Heijnen, and F. van Bel Cardiovascular Follow-up at School Age After Perinatal Glucocorticoid Exposure in Prematurely Born Children: Perinatal Glucocorticoid Therapy and Cardiovascular Follow-up Arch Pediatr Adolesc Med, August 1, 2008; 162(8): 738 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. K. Washburn, P. A. Nixon, and T. M. O'Shea Follow-up of a Randomized, Placebo-Controlled Trial of Postnatal Dexamethasone: Blood Pressure and Anthropometric Measurements at School Age Pediatrics, October 1, 2006; 118(4): 1592 - 1599. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. T. Wilson, L. Waters, C. C. Patterson, C. G. McCusker, N. M. Rooney, N. Marlow, and H. L. Halliday Neurodevelopmental and Respiratory Follow-up Results at 7 Years for Children From the United Kingdom and Ireland Enrolled in a Randomized Trial of Early and Late Postnatal Corticosteroid Treatment, Systemic and Inhaled (the Open Study of Early Corticosteroid Treatment). Pediatrics, June 1, 2006; 117(6): 2196 - 2205. [Abstract] [Full Text] [PDF]
|
|
