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Association of time of first corticosteroid treatment with bronchopulmonary dysplasia in preterm infants
Author(s) -
Cuna Alain,
Lagatta Joanne M.,
Savani Rashmin C.,
VyasRead Shilpa,
Engle William A.,
Rose Rebecca S.,
DiGeronimo Robert,
Logan J. Wells,
Mikhael Michel,
Natarajan Girija,
Truog William E.,
Kielt Matthew,
Murthy Karna,
Zaniletti Isabella,
Lewis Tamorah R.
Publication year - 2021
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.25610
Subject(s) - medicine , bronchopulmonary dysplasia , gestational age , pediatrics , odds ratio , corticosteroid , retrospective cohort study , birth weight , logistic regression , gestation , population , cohort study , cohort , low birth weight , pregnancy , genetics , environmental health , biology
Objective To evaluate the association between the time of first systemic corticosteroid initiation and bronchopulmonary dysplasia (BPD) in preterm infants. Study design A multi‐center retrospective cohort study from January 2010 to December 2016 using the Children's Hospitals Neonatal Database and Pediatric Health Information System database was conducted. The study population included preterm infants <32 weeks' gestation treated with systemic corticosteroids after 7 days of age and before 34 weeks' postmenstrual age. Stepwise multivariable logistic regression was used to assess the association between timing of corticosteroid initiation and the development of Grade 2 or 3 BPD as defined by the 2019 Neonatal Research Network criteria. Results We identified 598 corticosteroid‐treated infants (median gestational age 25 weeks, median birth weight 760 g). Of these, 47% (280 of 598) were first treated at 8–21 days, 25% (148 of 598) were first treated at 22–35 days, 14% (86 of 598) were first treated at 36–49 days, and 14% (84 of 598) were first treated at >50 days. Infants first treated at 36‐49 days (aOR 2.0, 95% CI 1.1–3.7) and >50 days (aOR 1.9, 95% CI 1.04–3.3) had higher independent odds of developing Grade 2 or 3 BPD when compared to infants treated at 8–21 days after adjusting for birth characteristics, admission characteristics, center, and co‐morbidities. Conclusions Among preterm infants treated with systemic corticosteroids in routine clinical practice, later initiation of treatment was associated with a higher likelihood to develop Grade 2 or 3 BPD when compared to earlier treatment.