Neonatal Hydrocortisone Treatment: Neurodevelopmental Outcome and MRI at School Age in Preterm-born Children

Objective

To investigate neurodevelopment at school age in preterm infants treated with hydrocortisone for bronchopulmonary dysplasia (BPD) in the neonatal period.

Study design

Preterm infants (n = 226; gestational age ≤32 weeks and/or body weight ≤1500 grams) performed subtests of the Wechsler Intelligence Scale for Children-Revised, the Visual Motor Integration test, a 15-Word Memory Test and the Movement Assessment Battery for Children at school age. Conventional MRI of the brain was obtained. Sixty-two children who received hydrocortisone for BPD (starting dose, 5 mg/kg/day; median duration, 27.5 days) were compared with 164 nontreated neonates.

Results

Hydrocortisone-treated infants were younger, lighter, and sicker than their non–steroid-treated counterparts. Adjustments for gestational age, body weight, sex, mechanical ventilation, and small for gestational age were made. Adjusted mean Intelligence Quotient, Visual Motor Integration test, and memory test results were the same in the hydrocortisone-treated group and the non–steroid-treated group (99 versus 101, P = .62; 97 versus 99, P = .49, 7.9 versus 7.5, P = .42, respectively). Motor function and incidence of cerebral palsy in both groups was not different (11% versus 7%, P = .97). Occurrence of brain lesions on MRI was similar for the two groups.

Conclusions

Neonatal hydrocortisone treatment for BPD had no long-term effects on neurodevelopment.

Abbreviations: BPD, Bronchopulmonary dysplasia, BW, Birth weight, CP, Cerebral palsy, DXM, Dexamethasone, GA, Gestational age, IQ, Intelligence quotient, IQR, Interquartile range, IVH, Intraventricular hemorrhage, Movement ABC, Movement Assessment Battery for Children, MRI, Magnetic resonance imaging, NICU, Neonatal intensive care unit, PDA, Patent ductus arteriosus, PVL, Periventricular leukomalacia, TIS, Total impairment score, VMI, Visual-motor integration