Randomised trial of early neonatal hydrocortisone demonstrates potential undesired effects on neurodevelopment at preschool age. (5th November 2015)

• Record Type: Journal Article
• Authors: Peltoniemi, Outi M.; Lano, Aulikki; Yliherva, Anneli; Kari, M Anneli; Hallman, Mikko
• Is Part Of: Acta pædiatrica. Volume 105:Number 2(2016:Feb.)
• Page Start: 159
• Page End: 164
• Publication Date: 2015-11-05
• Subjects: Cerebral palsy -- Growth -- Hydrocortisone -- Neurodevelopment -- Post‐natal corticosteroids; Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.13074
• Languages: English
• ISSNs: 0803-5253

Abstract

Abstract: Aim: We evaluated the neurodevelopment and growth of five‐ to seven‐year‐old children who had participated in a randomised trial of early low‐dose hydrocortisone treatment to prevent bronchopulmonary dysplasia. Methods: The 51 infants in the original study had birthweights of 501–1250 g and gestational ages of 23–30 weeks, required mechanical ventilation during the first 24 hours and received hydrocortisone or a placebo for 10 days. The majority (80%) of the 90% who survived to five‐ to seven years of age participated in this follow‐up study and their growth, neuromotor, cognitive and speech development were evaluated. Results: Some neurodevelopment impairment was observed in 61% of the hydrocortisone group and 39% of the placebo group, ranging from minor neurological dysfunction to severe neurological conditions (p = 0.182). The mean full‐scale intelligence quotient (IQ) was 87.8 (15.3) in the hydrocortisone group and 95.7 (15.0) in the placebo group (p = 0.135), and the mean performance IQ was 88.3 (14.5) and 99.1 (14.0) (p = 0.034), respectively. A fifth (22%) of the hydrocortisone group required physiotherapy, but none of the placebo group did (p = 0.034). The age‐standardised growth was comparable between both groups. Conclusion: Early hydrocortisone treatment may have undesired effects on neurodevelopment at preschool age, and further safety studies are required.