International Journal of Pediatrics / 2012 / Article / Tab 2

Review Article

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 followupFollowup, % (no. of infants seen)Treatment start timeDexamethasone dosing regimenPrimary neurodevelopmental findings

McEvoy et al. [25], 1 year66 (39)At 7–21 daysHigh versus low dose: 7-day taper from 0.5 mg/kg/day versus 0.2 mg/kg/dayMDI < 70: 24% (high) versus 17% (low) (NS);
CP: 10% versus 11% (NS)
Armstrong et al. [40], 18 months chronological age96 (64)On day 742-d taper versus 3-day pulseNo difference in 18-month outcomes
No disability: 34% versus 31% (NS)
Doyle et al. [41], 2 years corrected age98 (58)After 7 days0.15 mg/kg/day tapered over 10 daysDeath 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 age74 (123)On day 10.15 mg/kg/day tapered over 7 daysMDI < 70: 51% versus 43% (NS); PDI < 70: 30% versus 35% (NS); abnormal neurologic exam: 25% each group
Romagnoli et al. [43], 3 years100 (30)On day 40.5 mg/kg/day tapered over 1 wkNo differences in any parameter; CP: 9% versus 14% (NS)
Wilson et al. [44], 7 years84 (127)Before 3 days4 groups: 0.5 mg/kg/day tapered over 12 days versus late (15 days) selective, versus inhaled early or late selectiveNo difference in cognitive, behavioral, CP, or combined outcomes
Yeh et al. [45], school age (mean: 8 years)92 (146)On day 10.5 mg/kg/day for 1 wk, then tapered for a total of 28 daysTreated children were shorter ( ), had smaller head circumference ( ), lower IQ scores ( ), and more significant disabilities (CP, IQ < 5th percentile, vision or hearing impairment): 39% versus 22% ( )
O'Shea et al. [46], 4–11 years89 (84)On day 15–250.5 mg/kg/day tapered over 42 days versus placeboDeath or major NDI: 47% versus 41% (NS); major NDI alone: 36% versus 14% (P =.01)
Gross et al. [47], 15 years100 (22)On day 140.5 mg/kg/day tapered over 42 days versus 18-day taper versus placeboIntact survival (IQ > 70, normal neurologic exam, regular classroom): 69% versus 25% (18-d course) versus 18% (placebo) ( )
Jones and the Collaborative Dexamethasone Trial Follow-up Group [48], 13–17 years95 (150)At 2–12 wk0.5 mg/kg/day for 7 daysNo 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.

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