Evolving neonatal steroid prescription habits and patient outcomes. (15th May 2013)

• Record Type: Journal Article
• Authors: Fortin‐Pellerin, Étienne; Petersen, Claire; Lefebvre, Francine; Barrington, Keith J; Janvier, Annie
• Is Part Of: Acta pædiatrica. Volume 102:Number 8(2013:Aug.)
• Page Start: 799
• Page End: 804
• Publication Date: 2013-05-15
• Subjects: Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.12285
• Languages: English
• ISSNs: 0803-5253

Abstract

<abstract abstract-type="main" xml:lang="en" id="apa12285-abs-0001"> <title>Abstract</title> <sec id="apa12285-sec-0001" sec-type="section"> <title>Aim</title> <p>Indications for post‐natal steroids among preterm infants are evolving. The objective of this study was to compare steroid use in 2 cohorts 5 years apart and to document the short‐ and long‐term outcomes of our most recent cohort.</p> </sec> <sec id="apa12285-sec-0002" sec-type="section"> <title>Methods</title> <p>Retrospective chart review of infants born under 28 weeks of gestational age for two cohorts (January 2002‐August 2003 and July 2008‐March 2010).</p> </sec> <sec id="apa12285-sec-0003" sec-type="section"> <title>Results</title> <p>Two hundred and fourteen infants were included. More infants received steroids in the later cohort (20% vs 35%, p = 0.021) but survival rates did not improve. There was a shift towards hydrocortisone use (<7% vs 76%) and pulmonary indications (36% vs 61% of courses; p = 0.021). Patients died later (8 days vs 30 days; p = 0.02), with a strong correlation between time of death and total dose of steroids (r = 0.91; p = 0.01). Neurodevelopmental outcomes for patients who received steroids for pulmonary indications were inferior to those for the rest of the cohort (severe adverse outcome 26% vs 4.8%, p = 0.03).</p> </sec> <sec id="apa12285-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The improvement in short‐term respiratory status of ill preterm patients was offset by a disturbing increase in age at death and no improvement in survival rates.</p> </sec> </abstract>