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

Table 2

Neurodevelopmental follow-up of dexamethasone RCTs reported after 2001.

Study, planned age at followup	Followup, % (no. of infants seen)	Treatment start time	Dexamethasone dosing regimen	Primary neurodevelopmental findings
McEvoy et al. [25], 1 year	66 (39)	At 7–21 days	High versus low dose: 7-day taper from 0.5 mg/kg/day versus 0.2 mg/kg/day	MDI < 70: 24% (high) versus 17% (low) (NS); CP: 10% versus 11% (NS)
Armstrong et al. [40], 18 months chronological age	96 (64)	On day 7	42-d taper versus 3-day pulse	No difference in 18-month outcomes; No disability: 34% versus 31% (NS)
Doyle et al. [41], 2 years corrected age	98 (58)	After 7 days	0.15 mg/kg/day tapered over 10 days	Death or major disability: 46% versus 43% (NS); death or CP: 23% versus 37% (NS); CP: 14% versus 22% (NS); major disability 41% versus 31% (NS)
Stark et al. [42], 18–22 months corrected age	74 (123)	On day 1	0.15 mg/kg/day tapered over 7 days	MDI < 70: 51% versus 43% (NS); PDI < 70: 30% versus 35% (NS); abnormal neurologic exam: 25% each group
Romagnoli et al. [43], 3 years	100 (30)	On day 4	0.5 mg/kg/day tapered over 1 wk	No differences in any parameter; CP: 9% versus 14% (NS)
Wilson et al. [44], 7 years	84 (127)	Before 3 days	4 groups: 0.5 mg/kg/day tapered over 12 days versus late (15 days) selective, versus inhaled early or late selective	No difference in cognitive, behavioral, CP, or combined outcomes
Yeh et al. [45], school age (mean: 8 years)	92 (146)	On day 1	0.5 mg/kg/day for 1 wk, then tapered for a total of 28 days	Treated children were shorter (𝑃=.03), had smaller head circumference (𝑃=.04), lower IQ scores (𝑃=.008), and more significant disabilities (CP, IQ < 5th percentile, vision or hearing impairment): 39% versus 22% (𝑃=.04)
O'Shea et al. [46], 4–11 years	89 (84)	On day 15–25	0.5 mg/kg/day tapered over 42 days versus placebo	Death or major NDI: 47% versus 41% (NS); major NDI alone: 36% versus 14% (P =.01)
Gross et al. [47], 15 years	100 (22)	On day 14	0.5 mg/kg/day tapered over 42 days versus 18-day taper versus placebo	Intact survival (IQ > 70, normal neurologic exam, regular classroom): 69% versus 25% (18-d course) versus 18% (placebo) (𝑃<.05)
Jones and the Collaborative Dexamethasone Trial Follow-up Group [48], 13–17 years	95 (150)	At 2–12 wk	0.5 mg/kg/day for 7 days	No difference in moderate/severe disability (defined as IQ > 2 SDs < mean, CP, hearing or vision loss); CP: 24% versus 15% (relative risk: 1.58 [95% confidence interval: 0.81–3.07])

NDI: neurodevelopmental impairment; PDI: psychomotor developmental index; NS: not significant.