Published online October 2, 2006
PEDIATRICS Vol. 118 No. 4 October 2006, pp. 1592-1599 (doi:10.1542/peds.2006-0973)
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ARTICLE

Follow-up of a Randomized, Placebo-Controlled Trial of Postnatal Dexamethasone: Blood Pressure and Anthropometric Measurements at School Age

Lisa K. Washburn, MDa, Patricia A. Nixon, PhDa,b and T. Michael O'Shea, MD, MPHa

a Department of Pediatrics, School of Medicine
b Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina

OBJECTIVE. The purpose of this work was to evaluate the effects of a 42-day tapering course of dexamethasone on blood pressure and anthropometric measurements in school-age children who were born with very low birth weight.

METHODS. Sixty-eight children, who as neonates participated in a randomized placebo-controlled trial of a 42-day tapering course of dexamethasone (n = 38, dexamethasone; n = 30, placebo) to facilitate weaning from the ventilator, were seen at a median of 9 years of age. Participants underwent measurements of systolic blood pressure, diastolic blood pressure, mid-arm circumference, triceps skinfold thickness, height, and weight. Mann-Whitney U tests were used to compare groups, and Spearman coefficients were used to examine correlations between variables.

RESULTS. Comparing dexamethasone- and placebo-treated children, we found no differences in systolic blood pressure, mid-arm circumference, triceps skinfold thickness, height, weight, or body mass index. Twenty-nine percent of all subjects had systolic blood pressure and/or diastolic blood pressure ≥90th percentile for age and gender. Thirty percent of all subjects had body mass index ≥85th percentile for age and gender.

CONCLUSIONS. In a group of preterm very low birth-weight infants at high risk for chronic lung disease, we found no effects of dexamethasone on blood pressure or anthropometric measurements at 8 to 11 years of age. Of concern is that a high proportion in this sample had blood pressure ≥90th percentile and/or body mass index ≥85th percentile.

Key Words: prematurity • children • glucocorticoid • very low birth weight • growth

Abbreviations: VLBW—very low birth weight • CLD—chronic lung disease • GCRC—General Clinic Research Center • BMI—body mass index • SBP—systolic blood pressure • DBP—diastolic blood pressure

Accepted May 25, 2006.