TABLE 2

Neurodevelopmental Follow-up of Dexamethasone RCTs Reported After 2001

Study, Planned Age at Follow-upFollow-up, % (No. of Infants Seen)Treatment Start TimeDexamethasone Dosing RegimenPrimary Neurodevelopmental Findings
McEvoy et al,17 1 y66 (39)At 7–21 dHigh vs low dose: 7-d taper from 0.5 mg/kg per d vs 0.2 mg/kg per dMDI < 70: 24% (high) vs 17% (low) (NS); CP: 10% vs 11%(NS)
Armstrong et al,24 18 mo chronological age96 (64)On day 742-d taper vs 3-d pulseNo difference in 18-mo outcomes
No disability: 34% vs 31%(NS)
Doyle et al,25 2 y corrected age98 (58)After 7 d0.15 mg/kg per d tapered over 10 dDeath or major disability: 46% vs 43% (NS); death or CP: 23% vs 37% (NS); CP: 14% vs 22% (NS); major disability 41% vs 31%(NS)
Stark et al,26 18–22 mo corrected age74 (123)On day 10.15 mg/kg per d tapered over 7 dMDI < 70: 51% vs 43% (NS); PDI < 70: 30% vs 35%(NS); abnormal neurologic exam: 25% each group
Romagnoli et al,27 3 y100 (30)On day 40.5 mg/kg per d tapered over 1 wkNo differences in any parameter; CP: 9% vs 14%(NS)
Wilson et al,28 7 y84 (127)Before 3 d4 groups: 0.5 mg/kg per d tapered over 12 d vs late(15 d) selective, vs inhaled early or late selectiveNo difference in cognitive, behavioral, CP, or combined outcomes
Yeh et al,29 school age (mean: 8 y)92 (146)On day 10.5 mg/kg per d for 1 wk, then tapered for a total of 28 dTreated children were shorter(P = .03), had smaller head circumference (P = .04), lower IQ scores (P = .008), and more significant disabilities (CP, IQ < 5th percentile, vision or hearing impairment): 39% vs 22% (P = .04)
O'Shea et al,30 4–11 y89 (84)On day 15–250.5 mg/kg per d tapered over 42 d vs placeboDeath or major NDIa: 47% vs 41% (NS); major NDI alone: 36% vs 14% (P = .01)
Gross et al,31 15 y100 (22)On day 140.5 mg/kg per d tapered over 42 d vs 18-d taper vs placeboIntact survival (IQ > 70, normal neurologic exam, regular classroom): 69% vs 25% (18-d course) vs 18% (placebo)(P < .05)
Jones and the Collaborative Dexamethasone Trial Follow-up Group,32 13–17 y95 (150)At 2–12 wk0.5 mg/kg per d for 7 dNo difference in moderate/severe disability (defined as IQ > 2 SDs < mean, CP, hearing or vision loss); CP: 24% vs 15%(relative risk: 1.58 [95% confidence interval: 0.81–3.07])
  • MDI indicates Bayley Mental Developmental Index; NS, not significant. PDI, Bayley Psychomotor Development Index; NDI, neurodevelopmental impairment.

  • a Major neurodevelopmental impairment included CP and/or an IQ score of <70.