International Journal of Pediatrics / 2012 / Article / Tab 1

Review Article

Postnatal Corticosteroids for Prevention and Treatment of Chronic Lung Disease in the Preterm Newborn

Table 1

RCTs of dexamethasone to prevent or treat BPD reported since 2001.

Study, no. of centersnEligibility criteria (all on mechanical ventilation)TimingDexamethasone dosing regimenOutcome

McEvoy et al. [25], 1 center62500–1500 g BW; ≤32 wk gestation7–21 postnatal days5 mg/kg/day tapered over 7 days versus 0.2 mg/kg tapered over 7 daysRate of survival without BPD 76% versus 73% (NS); no benefit to higher dose
Odd et al. [26], 1 center33≤1250 g BW1–3 wk of age0.5 mg/kg/day tapered over 42 days versus “individualize” (same dose, shorter course)Rate of survival without BPD: 24% versus 30% (NS); no difference in 18-month outcomes
Malloy et al. [27], 1 center16<1501 g BW; <34 wk gestation<28 postnatal days0.5 mg/kg/day tapered over 7 days versus 0.08 mg/kg/day for 7 daysRate of survival without BPD: 11% versus 38% (NS); higher dose had more adverse effects, no apparent benefit
Walther et al. [28], 1 center36≥600 g BW; 24–32 wk gestation7–14 d postnatal age0.2 mg/kg/day tapered over 14 days versus placeboRate of survival without BPD: 65% versus 47% (NS); extubation: 76% versus 42% ( )
Anttila et al. [29], 6 centers109500–999 g BW; ≤31 wk gestationEligible at 4 h of age0.25 mg/kg every 12 h × 4 doses versus placeboRate of survival without BPD: 58% versus 52% (NS)
Doyle et al. [30], 11 centers70<1000 g BW; <28 wk gestation >1 wk postnatal age0.25 mg/kg every 12 h × 4 doses versus placeboRate of survival without BPD: 14% versus 9% (NS); extubation: 60% versus 12% (odds ratio: 11.2 (95% confidence interval: 3.2–39.0))
Rozycki et al. [31], 1 center61650–2000 g BW≥14 day postnatal age0.5 mg/kg/day tapered over 42 day versus inhaled beclomethasone at 3 different doses for 7 days followed by the above-listed dexamethasone course, if still mechanically ventilatedRate of survival without BPD: 53% versus 46% (NS); extubation by 7 d: 7 of 15 versus 6 of 46 ( )

BW = body weight; NS = not significant.

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