TABLE 3

RCTs of Early Hydrocortisone to Prevent BPD

Study, No. of CentersnPopulation: Mechanically Ventilated InfantsHydrocortisone Dosing RegimenRate of Survival Without BPDa HC vs Placebo, %
Watterberg et al,38 2 centers40500–999 g BW; <48 h postnatal age0.5 mg/kg every 12 h for 9 d60 vs 35(P = .04)
0.25 mg/kg every 12 h for 3 d
Watterberg et al,39 9 centers360b500–999 g BW; <48 h postnatal age0.5 mg/kg every 12 h for 12 d35 vs 34(aORc: 1.20 [95% CI: 0.72–1.99])
0.25 mg/kg every 12 h for 3 d
Peltoniemi et al,40 3 centers51b501–1250 g BW; <36 h postnatal age2.0 mg/kg per d tapered to 0.75 mg/kg per d over 10 d64 vs 46(OR: 1.48 [95% CI: 0.49–4.48])
Bonsante et al,41 2 centers50b500–1249 g BW; <48 h postnatal age0.5 mg/kg every 12 h for 9 d; 0.25 mg/kg every 12 h for 3 d64 vs 32(P < .05)
Total601
  • BW indicates birth weight; aOR, adjusted odds ratio; OR, odds ratio; CI, confidence interval.

  • a BPD was defined as receiving supplemental oxygen at 36 weeks' postmenstrual age.

  • b Study enrollment was terminated early because of concern for spontaneous gastrointestinal perforation.

  • c Adjusted for center, birth weight, risk factors (gender, “outborn” [infants who were born at an outlying institution and transported into the study center], white race, vaginal delivery, no prenatal steroids, hydrocortisone, and/or vasopressor support at study entry).