Systemic corticosteroid use and neurodevelopmental outcomes in preterm infants: a cohort study.

IF 4.5 2区医学 Q1 PEDIATRICS

World Journal of Pediatrics Pub Date : 2025-06-01 Epub Date: 2025-06-27 DOI:10.1007/s12519-025-00932-4

Adithya Shastry, Danish Ahmad, Alice Richardson, Barbara Bajuk, Traci-Anne Goyen, Pranav R Jani, Mohamed E Abdel-Latif

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引用次数: 0

Abstract

Background: The risk-benefit balance and safety of postnatal corticosteroid use for chronic lung disease (PNCSCLD) in preterm infants is a controversial matter. Our objective was to determine the trends in the use of PNCSCLD over eleven years and to analyze the neurodevelopmental consequences of PNCSCLD in preterm infants at 18-42 months of corrected age.

Methods: The data for this retrospective population-based cohort study were obtained from ten tertiary neonatal intensive care units across New South Wales and the Australian Capital Territory, Australia. Preterm infants < 29⁺⁰ weeks' gestation born between January 1, 2007, and December 31, 2017, who were alive at discharge, without any major congenital anomalies were included and analyzed based on their PNCSCLD status.

Results: Over eleven years, 611 (14.3%) out of 4258 infants received PNCSCLD. Among the 3386 eligible infants, 2636 (77.8%) underwent neurodevelopmental follow-up and were included in the final analysis. The rate of PNCSCLD use increased from 12.4% in 2007 to 19.6% in 2017. Similarly, the rate of moderate to severe functional disability (MSFD) increased from 8.8% in 2007 to 16.1% in 2017. Propensity-adjusted analysis revealed a greater odds ratio (OR) for MSFD in the PNCSCLD group than in the control group [average treatment effect: OR = 1.252, 95% confidence interval (CI) = 1.185-1.322, P ≤ 0.001; average treatment effect on the treated group: OR = 1.104, 95% CI = 1.031-1.184, P = 0.005].

Conclusions: PNCSCLD use was associated with a greater incidence of MSFD. Clinicians should exercise caution when using PNCSCLD.

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系统性皮质类固醇使用与早产儿神经发育结局：一项队列研究。

背景：产后使用皮质类固醇治疗早产儿慢性肺部疾病（PNCSCLD）的风险-收益平衡和安全性是一个有争议的问题。我们的目的是确定11年来PNCSCLD的使用趋势，并分析PNCSCLD对18-42个月矫正月龄早产儿神经发育的影响。方法：这项以人群为基础的回顾性队列研究的数据来自澳大利亚新南威尔士州和澳大利亚首都地区的10个三级新生儿重症监护病房。纳入2007年1月1日至2017年12月31日出生、出院时存活且无重大先天性异常的0周以上早产儿，根据其PNCSCLD状态进行分析。结果：在11年中，4258名婴儿中有611名（14.3%）接受了PNCSCLD。在3386名符合条件的婴儿中，2636名（77.8%）接受了神经发育随访，并被纳入最终分析。PNCSCLD的使用率从2007年的12.4%上升到2017年的19.6%。同样，中度至重度功能残疾率（MSFD）从2007年的8.8%上升到2017年的16.1%。倾向校正分析显示，PNCSCLD组MSFD的优势比（OR）大于对照组[平均治疗效果：OR = 1.252, 95%可信区间(CI) = 1.185-1.322, P≤0.001；治疗组平均治疗效果：OR = 1.104, 95% CI = 1.031-1.184, P = 0.005。结论：PNCSCLD的使用与更高的MSFD发生率相关。临床医生在使用PNCSCLD时应谨慎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Pediatrics 医学-小儿科

CiteScore

10.50

自引率

1.10%

发文量

592

审稿时长

2.5 months

期刊介绍： The World Journal of Pediatrics, a monthly publication, is dedicated to disseminating peer-reviewed original papers, reviews, and special reports focusing on clinical practice and research in pediatrics. We welcome contributions from pediatricians worldwide on new developments across all areas of pediatrics, including pediatric surgery, preventive healthcare, pharmacology, stomatology, and biomedicine. The journal also covers basic sciences and experimental work, serving as a comprehensive academic platform for the international exchange of medical findings.