Effects of postnatal glucocorticoids on brain structure in preterm infants, a scoping review

Neurosci Biobehav Rev. 2023 Feb:145:105034. doi: 10.1016/j.neubiorev.2023.105034. Epub 2023 Jan 3.

Abstract

Glucocorticoids (GC) are used in neonatal intensive care units to prevent or reduce the severity of chronic lung disease in preterm infants and have been implicated in impaired neurodevelopment. Our objective was to identify what is known about the effects of postnatal GC treatment in human preterm infants on structural brain development and to identify gaps in the literature. Following Arksey and O'Malley's scoping review methodological framework, we searched scientific literature databases for original research on human preterm infants, postnatal GCs, and brain structure. 11 studies assessed the effects of GCs on structural brain outcomes. 56 studies reported brain injury, but not structure. Dexamethasone was consistently associated with decreased total and regional brain volumes, including cerebellar volumes. Hydrocortisone was often, but not always associated with absence of brain volume differences. No studies examined the impact of inhaled GC on brain structure. Additional research on the effects of neonatal GCs after preterm birth on a variety of structural brain measures is required for understanding contributions to neurodevelopment and informing practice guidelines.

Keywords: Brain; Glucocorticoids; Human; Imaging; Prematurity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Scoping Review

MeSH terms

  • Anti-Inflammatory Agents
  • Brain / diagnostic imaging
  • Chronic Disease
  • Dexamethasone
  • Female
  • Glucocorticoids*
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Premature Birth*

Substances

  • Glucocorticoids
  • Anti-Inflammatory Agents
  • Dexamethasone