Effects of postnatal glucocorticoids on brain structure in preterm infants, a scoping review. (February 2023)

• Record Type: Journal Article
• Authors: Robles, Isabella; Eidsness, Margarita Alethea; Travis, Katherine E.; Feldman, Heidi M.; Dubner, Sarah E.
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 145(2023)
• Publication Date: 2023-02
• Subjects: Glucocorticoids -- Prematurity -- Brain -- Imaging -- Human; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2023.105034
• Languages: English
• ISSNs: 0149-7634

Abstract

Abstract: Glucocorticoids (GC) are used in neonatal intensive care units to prevent or reduce the severity of chronic lung disease in preterm infants and have been implicated in impaired neurodevelopment. Our objective was to identify what is known about the effects of postnatal GC treatment in human preterm infants on structural brain development and to identify gaps in the literature. Following Arksey and O'Malley's scoping review methodological framework, we searched scientific literature databases for original research on human preterm infants, postnatal GCs, and brain structure. 11 studies assessed the effects of GCs on structural brain outcomes. 56 studies reported brain injury, but not structure. Dexamethasone was consistently associated with decreased total and regional brain volumes, including cerebellar volumes. Hydrocortisone was often, but not always associated with absence of brain volume differences. No studies examined the impact of inhaled GC on brain structure. Additional research on the effects of neonatal GCs after preterm birth on a variety of structural brain measures is required for understanding contributions to neurodevelopment and informing practice guidelines. Highlights: Few studies examine postnatal glucocorticoid effects on preterm human brain structure. Dexamethasone use in preterm infants is associated with reduced overall brain volumes. Dexamethasone use in preterm infants is associated with reduced cerebellar volumes. Hydrocortisone use in preterm infants is not consistently correlated with adverse brain effects. Studies of glucocorticoid use in preterm infants should assess brain structures.