Background. Corticosteroids are used to prevent and treat bronchopulmonary dysplasia (BPD), but also affect normal development, including the expression of growth factors such as VEGF.

Methods. Deep pulmonary lavage (DPL) specimens were collected on days of life 1, 3, 7 and 28 in 35 preterm infants ≤ 33 wks gestational age at birth during a randomized, controlled trial of two doses of dexamethasone(DEX) (0.5 mg/kg IV) at 12 and 24 hrs of age for BPD prevention. VEGF was measured by enzyme-linked immunosorbent assay with dilution correction by the urea method.

Results. There were 14 DEX and 21 control subjects, with similar gestational ages (27 ± 3 vs. 28 ± 3 wks) and birthweights (1009± 439 vs. 1043 ± 500 gm), but differing FiO2s (0.36± 0.21 vs. 0.25 ± 0.04, p = 0.03) at study entry. All subjects received surfactant. VEGF rose above day 1 levels by day 3 in both groups (p< 0.05). The rise abated by day 7 in controls (p = 0.02), but not DEX subjects. However, day 7 group means did not differ (p = 0.20). DEX and control values were similar at day 28.

Conclusions. VEGF in DPL fluid rises during early postnatal life in preterm infants. This rise may be prolonged by the use of DEX. The effects of these changes on angiogenesis merits further study.

Supported by NHLBI SCOR HL-36543, R01 HL-54632, K08 HL-02630.Figure

figure 1