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PEDIATRICS Vol. 107 No. 6 June 2001, pp. 1425-1426

COMMENTARY:
Postnatal Steroids and Neurodevelopmental Outcomes: A Problem In the Making

The first 20% of the full text of this article appears below.

Steroids have been given in pharmacologic doses for the prevention or treatment of bronchopulmonary dysplasia since initial reports in the 1970s showed acute improvements in respiratory status.1 Since then there have been >40 randomized, controlled trials evaluating their use. It is now clear that this treatment leads to an acute increase in lung mechanics and gas exchange in the injured lung, leading to a reduction in requirements for assisted ventilation,2 but there is no published long-term pulmonary outcome data.

Postnatal steroids in pharmacologic doses impair growth, including growth of the brain, leading to dramatic reductions in cortical gray matter volumes.3 Other short-term morbidities include hyperglycemia, hypertension, cardiac hypertrophy, gastrointestinal hemorrhage and perforation,4,5 sepsis,2 and periventricular leukomalacia.4,6 Despite the large numbers of randomized infants (>2300) only 8 studies (679 infants) reporting neurodevelopmental outcomes were found for a systematic review just published in BioMed Central Pediatrics7 a new on-line journal, with rigorous and completely open peer review, which is linked to the PubMed Central project of the National Institutes . . . [Full Text of this Article]


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