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Postnatal steroids in extremely low birth weight infants: betamethasone or hydrocortisone?
Author(s) -
Ben Said Mohamed,
Hays Stéphane,
Loys ClaireMarie,
Coletto Ludivine,
Godbert Isabelle,
Picaud JeanCharles
Publication year - 2013
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12255
Subject(s) - medicine , betamethasone , bronchopulmonary dysplasia , low birth weight , birth weight , blood pressure , pediatrics , prospective cohort study , corticosteroid , weaning , hydrocortisone , retrospective cohort study , anesthesia , gestational age , pregnancy , biology , genetics
Aim To compare the efficacy and tolerance of betamethasone ( BTM ) and hydrocortisone ( HC ) in weaning extremely low birth weight ( ELBW ) infants with bronchopulmonary dysplasia ( BPD ) from the ventilator. Methods Monocentric, retrospective, cohort analysis based on prospective, standardized collection of data between 2005 and 2011 in ELBW receiving postnatal steroids ( PS ) after the second week of life. We used BTM for the first 4 years, and thereafter HC . We compared extubation rates, growth, glycaemia and blood pressure. Results Sixty‐seven infants received PS : 35 BTM and 32 HC . Most infants (83% BTM vs. 72% HC ) were extubated during treatment (p = 0.281). During PS , the need for insulin was similar. Mean arterial blood pressure was similar at day 3 of PS , but was significantly lower in infants treated by BTM 30 days after the end of treatment. The z‐scores for body weight and head circumference indicated significantly greater loss in BTM than HC group. This persisted only for body weight after adjustment for differences in energy intake and corticosteroid dose. Conclusion Our study suggests that HC may be as efficient as BTM in facilitating the extubation of ELBW infants, without short‐term adverse effects. Blood pressure monitoring and investigation of long‐term neurodevelopment are nevertheless needed.