Abstract
Background and aims: At present, hydrocortisone (HC) as well as dexamethasone (DXM) are used to treat preterm infants at risk for bronchopulmonary dysplasia. Our aim was to determine the influence of HC- and DXM-therapy in preterm infants on neurodevelopmental outcome assessed by the quality of general movements (GMs) until three months after term.
Methods: Thirty-six preterm infants were included, 18 infants received HC (BW range 630–1700 grams, GA range 24.9–31.0 weeks), 18 infants received DXM (BW range 700–1800 grams, GA range 26.0–30.3 weeks) in a mean cumulative equivalent cortisol dose of 113.3 mg/kg resp. 166.3 mg/kg. After videotape recording, we analyzed each recording on the quality of GMs as normal or abnormal. Additionally, we performed a Motor Optimality Score (MOS) on details of the GMs (range 5–28).
Results: No difference in GM quality was found between HC- and DXM infants, neither before treatment, nor in the first week after treatment or at term. At 3 months, HC infants had a higher median MOS than DXM infants (24 vs. 21, p =0.025). This effect became stronger after correction for equivalent dose of cortisol, BW and GA (p =0.005). In the DXM group, but not in the HC group, MOS on day 1 of treatment was lower than before treatment (10 vs. 11, p =0.030).
Conclusions: Our study indicates that the quality of GMs is impaired in DXM treated infants, in particular on the first day following treatment. HC treatment is associated with a better quality of GMs 3 months after term.
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Hitzert, M., Benders, M., Roescher, A. et al. 194 Hydrocortisone Versus Dexamethasone Treatment for Bronchopulmonary Dysplasia and Neurological Outcome in Preterm Infants. Pediatr Res 68 (Suppl 1), 101 (2010). https://doi.org/10.1203/00006450-201011001-00194
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DOI: https://doi.org/10.1203/00006450-201011001-00194