Long-term sequelae of postnatal surfactant and corticosteroid therapies for BPD

J Perinatol. 2008 Jul;28(7):498-504. doi: 10.1038/jp.2008.30. Epub 2008 Mar 27.

Abstract

Objective: This retrospective analysis assessed the relationship between medical treatment (postnatal steroids, surfactant) received neonatally and outcomes at 3 and 8 years using a longitudinal sample of children with bronchopulmonary dysplasia (BPD).

Study design: Four groups were formed retrospectively based on the type of neonatal medical treatment received: no drug intervention (n=37), surfactant only (n=29), postnatal steroids only (n=13) and combined surfactant and postnatal steroids (n=16). Groups were compared on neurological and medical outcomes.

Result: Combined postnatal steroids and surfactant treatment was associated with more days on supplemental oxygen than no intervention or surfactant only. Surfactant replacement therapy alone was not associated with adverse consequences; however, postnatal steroid exposure appeared to be related.

Conclusion: Although retrospective analyses make statements about causation impossible, the differential relationships of therapies with cognitive outcomes argues for careful monitoring of therapeutic agents with very low birth weight infants.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adrenal Cortex Hormones / adverse effects*
  • Bronchopulmonary Dysplasia / drug therapy*
  • Child
  • Child, Preschool
  • Drug Therapy, Combination
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Very Low Birth Weight
  • Intelligence / drug effects*
  • Longitudinal Studies
  • Male
  • Prospective Studies
  • Psychomotor Performance / drug effects*
  • Pulmonary Surfactants / adverse effects*
  • Retrospective Studies

Substances

  • Adrenal Cortex Hormones
  • Pulmonary Surfactants