Title
Extended course of prednisolone in infants with severe bronchopulmonary dysplasia.
Document Type
Article
Publication Date
9-2019
Identifier
DOI: 10.1016/j.earlhumdev.2019.06.007
Abstract
BACKGROUND: There are few published data on the efficacy and safety of prednisolone in preterm infants with bronchopulmonary dysplasia (BPD).
AIMS: To describe the use of chronic prednisolone therapy in a population of infants with severe BPD, examine potential benefits on respiratory status, and document potential effects on growth.
STUDY DESIGN: Single-center retrospective cohort study.
SUBJECTS: Preterm infants who had received ≥30 days of prednisolone for the treatment of severe BPD.
OUTCOME MEASURES: Weekly changes in Pulmonary Severity Score (PSS), as well as weekly changes in weight, length, and head circumference during prednisolone therapy.
RESULTS: Forty-three infants (mean birth weight 729 g; mean gestational age 26 weeks) were identified. The average age at start of prednisolone treatment was 42.5 ± 5.9 weeks; while the median duration and median cumulative dose of prednisolone therapy were 67 (IQR 57-107) days and 61.3 (IQR 39.9-93.3) mg/kg, respectively. PSS decreased after 1 week of prednisolone therapy (mean difference, 0.19; 95% Cl, 0.01 to 0.37; p = 0.03). No further reduction in PSS was noted despite continued treatment. Length z-scores decreased after 4 weeks of continued treatment (mean difference 0.6; 95% CI 0.01 to 1.1; P = 0.04), while weight and head circumference did not change.
CONCLUSIONS: In one of the first reports on prednisolone therapy for severe BPD, we describe that long-term prednisolone is associated with modest short-term improvement in PSS, but impairs linear growth. Our results suggest a risk-benefit profile of prednisolone that does not favor long-term use in infants with severe BPD.
Journal Title
Early human development
Volume
136
First Page
1
Last Page
6
MeSH Keywords
Bronchopulmonary Dysplasia; Child Development; Female; Glucocorticoids; Humans; Infant, Extremely Premature; Infant, Newborn; Male; Prednisolone
Keywords
Bronchopulmonary dysplasia; Corticosteroids; Growth; Outcome; Prednisolone; Prematurity
Recommended Citation
Linafelter, A., Cuna, A., Liu, C., Quigley, A., Truog, W. E., Sampath, V., Oschman, A. Extended course of prednisolone in infants with severe bronchopulmonary dysplasia. Early human development 136, 1-6 (2019).
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