Association between total hydrocortisone dose and neurodevelopmental outcome at 3 years old in newborns under 28 weeks of gestation

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development Pub Date : 2025-10-01 DOI:10.1016/j.braindev.2025.104452

Toshimitsu Takayanagi, Mizuko Hashimoto , Tada-Aki Shiraishi , Hiroyuki Tomino, Shun Ogiwara, Akinori Shichijo, Masakazu Egashira, Tomoko Mizukami, Tomoko Egashira

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引用次数: 0

Abstract

Background

Ventilated very-low-birth-weight infants (VLBWIs) frequently receive hydrocortisone (HDC). The HDC dose increases in more serious cases, but the association between the actual HDC dose and neurodevelopmental outcomes is unclear.

Method

A total of 274 VLBWIs were divided into four groups according to the total HDC dose: zero (0 mg/kg), low (1–25 mg/kg), moderate (25–75 mg/kg), high (>75 mg/kg). The developmental quotient (DQ) in each group were compared. Using simple and multiple linear regression analyses, we evaluated the presence of a significant relationship between total DQ and total HDC dose in 274 and 153 VLBWIs receiving HDC therapy. In addition, the association between HDC therapy and the total DQ was investigated in 274 VLBWIs.

Results

The total DQ in the zero group was significantly higher than that in the moderate and high groups but equivalent to that in the low group. Despite a significant association between total DQ and total HDC dose in the single linear regression analysis, no significant association was found between total DQ and total HDC dose in 274 VLBWIs (p = 0.07) and 153 VLBWIs receiving HDC (p = 0.18) using a multiple linear regression analysis, after adjusting for the days of artificial ventilation, gestational age, and the onset of late-stage circulatory collapse. No significant association was observed between total DQ and HDC therapy (p = 0.58).

Conclusion

HDC therapy during NICU admission may not have a significant effect on total DQ at three years old in VLBWIs.

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氢化可的松总剂量与妊娠28周以下3岁新生儿神经发育结局的关系

背景：通气过低出生体重儿（VLBWIs）经常接受氢化可的松（HDC）治疗。在更严重的病例中，HDC剂量增加，但实际HDC剂量与神经发育结果之间的关系尚不清楚。方法：将274例vlbwi按HDC总剂量分为4组：零组（0 mg/kg）、低组（1 ~ 25 mg/kg）、中组（25 ~ 75 mg/kg）、高组（0 ~ 75 mg/kg）。比较各组发育商（DQ）。使用简单和多元线性回归分析，我们评估了274和153名接受HDC治疗的vlbwi的总DQ和总HDC剂量之间存在显著关系。此外，研究了274例vlbwi患者的HDC治疗与总DQ之间的关系。结果：零组总DQ显著高于中、高组，与低组相当。尽管在单一线性回归分析中，总DQ和总HDC剂量之间存在显著相关性，但在调整人工通气天数、胎龄和晚期循环衰竭发作后，使用多元线性回归分析，274名vlbwi （p = 0.07）和153名接受HDC的vlbwi （p = 0.18）中，总DQ和总HDC剂量之间没有显著相关性。总DQ与HDC治疗无显著相关性（p = 0.58）。结论：新生儿重症监护病房入院时的HDC治疗对vlbw3岁时的总DQ无显著影响。

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

Brain & Development 医学-临床神经学

CiteScore

3.60

自引率

0.00%

发文量

153

审稿时长

50 days

期刊介绍： Brain and Development (ISSN 0387-7604) is the Official Journal of the Japanese Society of Child Neurology, and is aimed to promote clinical child neurology and developmental neuroscience. The journal is devoted to publishing Review Articles, Full Length Original Papers, Case Reports and Letters to the Editor in the field of Child Neurology and related sciences. Proceedings of meetings, and professional announcements will be published at the Editor''s discretion. Letters concerning articles published in Brain and Development and other relevant issues are also welcome.