Timing of postnatal steroids for bronchopulmonary dysplasia: association with pulmonary and neurodevelopmental outcomes

doi:10.1038/s41372-020-0594-4

Timing of postnatal steroids for bronchopulmonary dysplasia: association with pulmonary and neurodevelopmental outcomes

Pediatrics

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

Objective: To determine the associations between age at first postnatal corticosteroids (PNS) exposure and risk for severe bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI). Study design: Cohort study of 951 infants born <27 weeks gestational age at NICHD Neonatal Research Network sites who received PNS between 8 days of life (DOL) and 36 weeks’ postmenstrual age was used to produce adjusted odds ratios (aOR). Results: Compared with infants in the reference group (22–28 DOL-lowest rate), aOR for severe BPD was similar for children given PNS between DOL 8 and 49 but higher among infants treated at DOL 50–63 (aOR 1.77, 95% CI 1.03–3.06), and at DOL ≥64 (aOR 3.06, 95% CI 1.44–6.48). The aOR for NDI did not vary significantly by age of PNS exposure. Conclusion: For infants at high risk of BPD, initial PNS should be considered prior to 50 DOL for the lowest associated odds of severe BPD.

Original language	English
Pages (from-to)	616-627
Number of pages	12
Journal	Journal of Perinatology
Volume	40
Issue number	4
DOIs	https://doi.org/10.1038/s41372-020-0594-4
State	Published - Apr 1 2020

Bibliographical note

Funding Information:
Acknowledgements The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Center for Research Resources, and the National Center for Advancing Translational Sciences provided grant support for the Neonatal Research Network’s Generic Database and Follow-up Studies through cooperative agreements. While NICHD staff did have input into the study design, conduct, analysis, and manuscript drafting, the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Data collected at participating sites of the NICHD Neonatal Research Network (NRN) were transmitted to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, AD (DCC Principal Investigator) and Douglas Kendrick (DCC Statistician) had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study.

Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

Access to Document

10.1038/s41372-020-0594-4

Cite this

@article{720c0a25d2524e84b47167e9ce4c2744,

title = "Timing of postnatal steroids for bronchopulmonary dysplasia: association with pulmonary and neurodevelopmental outcomes",

abstract = "Objective: To determine the associations between age at first postnatal corticosteroids (PNS) exposure and risk for severe bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI). Study design: Cohort study of 951 infants born <27 weeks gestational age at NICHD Neonatal Research Network sites who received PNS between 8 days of life (DOL) and 36 weeks{\textquoteright} postmenstrual age was used to produce adjusted odds ratios (aOR). Results: Compared with infants in the reference group (22–28 DOL-lowest rate), aOR for severe BPD was similar for children given PNS between DOL 8 and 49 but higher among infants treated at DOL 50–63 (aOR 1.77, 95% CI 1.03–3.06), and at DOL ≥64 (aOR 3.06, 95% CI 1.44–6.48). The aOR for NDI did not vary significantly by age of PNS exposure. Conclusion: For infants at high risk of BPD, initial PNS should be considered prior to 50 DOL for the lowest associated odds of severe BPD.",

author = "Harmon, {Heidi M.} and Jensen, {Erik A.} and Sylvia Tan and Chaudhary, {Aasma S.} and Slaughter, {Jonathan L.} and Bell, {Edward F.} and Wyckoff, {Myra H.} and Hensman, {Angelita M.} and Sokol, {Gregory M.} and DeMauro, {Sara B.} and Caplan, {Michael S.} and Laptook, {Abbott R.} and Martin Keszler and Vohr, {Betty R.} and Barbara Alksninis and Basso, {Kristin M.} and Robert Burke and Melinda Caskey and Katharine Johnson and Keszler, {Mary Lenore} and Knoll, {Andrea M.} and Leach, {Theresa M.} and Emilee Little and McGowan, {Elisabeth C.} and Elisa Vieira and Watson, {Victoria E.} and Suzy Ventura and Walsh, {Michele C.} and Hibbs, {Anna Maria} and Wilson-Costello, {Deanne E.} and Newman, {Nancy S.} and Payne, {Allison H.} and Siner, {Bonnie S.} and Monika Bhola and Gulgun Yalcinkaya and Truog, {William E.} and Pallotto, {Eugenia K.} and Kilbride, {Howard W.} and Cheri Gauldin and Anne Holmes and Kathy Johnson and Allison Scott and Kurt Schibler and Donovan, {Edward F.} and Cathy Grisby and Kate Bridges and Barbara Alexander and Fischer, {Estelle E.} and Mincey, {Holly L.} and Goldstein, {Ricki F.}",

note = "Funding Information: Acknowledgements The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Center for Research Resources, and the National Center for Advancing Translational Sciences provided grant support for the Neonatal Research Network{\textquoteright}s Generic Database and Follow-up Studies through cooperative agreements. While NICHD staff did have input into the study design, conduct, analysis, and manuscript drafting, the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Data collected at participating sites of the NICHD Neonatal Research Network (NRN) were transmitted to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, AD (DCC Principal Investigator) and Douglas Kendrick (DCC Statistician) had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study. Publisher Copyright: {\textcopyright} 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.",

year = "2020",

month = apr,

day = "1",

doi = "10.1038/s41372-020-0594-4",

language = "English",

volume = "40",

pages = "616--627",

number = "4",

}

TY - JOUR

T1 - Timing of postnatal steroids for bronchopulmonary dysplasia

T2 - association with pulmonary and neurodevelopmental outcomes

AU - Harmon, Heidi M.

AU - Jensen, Erik A.

AU - Tan, Sylvia

AU - Chaudhary, Aasma S.

AU - Slaughter, Jonathan L.

AU - Bell, Edward F.

AU - Wyckoff, Myra H.

AU - Hensman, Angelita M.

AU - Sokol, Gregory M.

AU - DeMauro, Sara B.

AU - Caplan, Michael S.

AU - Laptook, Abbott R.

AU - Keszler, Martin

AU - Vohr, Betty R.

AU - Alksninis, Barbara

AU - Basso, Kristin M.

AU - Burke, Robert

AU - Caskey, Melinda

AU - Johnson, Katharine

AU - Keszler, Mary Lenore

AU - Knoll, Andrea M.

AU - Leach, Theresa M.

AU - Little, Emilee

AU - McGowan, Elisabeth C.

AU - Vieira, Elisa

AU - Watson, Victoria E.

AU - Ventura, Suzy

AU - Walsh, Michele C.

AU - Hibbs, Anna Maria

AU - Wilson-Costello, Deanne E.

AU - Newman, Nancy S.

AU - Payne, Allison H.

AU - Siner, Bonnie S.

AU - Bhola, Monika

AU - Yalcinkaya, Gulgun

AU - Truog, William E.

AU - Pallotto, Eugenia K.

AU - Kilbride, Howard W.

AU - Gauldin, Cheri

AU - Holmes, Anne

AU - Johnson, Kathy

AU - Scott, Allison

AU - Schibler, Kurt

AU - Donovan, Edward F.

AU - Grisby, Cathy

AU - Bridges, Kate

AU - Alexander, Barbara

AU - Fischer, Estelle E.

AU - Mincey, Holly L.

AU - Goldstein, Ricki F.

N1 - Funding Information: Acknowledgements The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Center for Research Resources, and the National Center for Advancing Translational Sciences provided grant support for the Neonatal Research Network’s Generic Database and Follow-up Studies through cooperative agreements. While NICHD staff did have input into the study design, conduct, analysis, and manuscript drafting, the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Data collected at participating sites of the NICHD Neonatal Research Network (NRN) were transmitted to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, AD (DCC Principal Investigator) and Douglas Kendrick (DCC Statistician) had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study. Publisher Copyright: © 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.

PY - 2020/4/1

Y1 - 2020/4/1

N2 - Objective: To determine the associations between age at first postnatal corticosteroids (PNS) exposure and risk for severe bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI). Study design: Cohort study of 951 infants born <27 weeks gestational age at NICHD Neonatal Research Network sites who received PNS between 8 days of life (DOL) and 36 weeks’ postmenstrual age was used to produce adjusted odds ratios (aOR). Results: Compared with infants in the reference group (22–28 DOL-lowest rate), aOR for severe BPD was similar for children given PNS between DOL 8 and 49 but higher among infants treated at DOL 50–63 (aOR 1.77, 95% CI 1.03–3.06), and at DOL ≥64 (aOR 3.06, 95% CI 1.44–6.48). The aOR for NDI did not vary significantly by age of PNS exposure. Conclusion: For infants at high risk of BPD, initial PNS should be considered prior to 50 DOL for the lowest associated odds of severe BPD.

AB - Objective: To determine the associations between age at first postnatal corticosteroids (PNS) exposure and risk for severe bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI). Study design: Cohort study of 951 infants born <27 weeks gestational age at NICHD Neonatal Research Network sites who received PNS between 8 days of life (DOL) and 36 weeks’ postmenstrual age was used to produce adjusted odds ratios (aOR). Results: Compared with infants in the reference group (22–28 DOL-lowest rate), aOR for severe BPD was similar for children given PNS between DOL 8 and 49 but higher among infants treated at DOL 50–63 (aOR 1.77, 95% CI 1.03–3.06), and at DOL ≥64 (aOR 3.06, 95% CI 1.44–6.48). The aOR for NDI did not vary significantly by age of PNS exposure. Conclusion: For infants at high risk of BPD, initial PNS should be considered prior to 50 DOL for the lowest associated odds of severe BPD.

UR - http://www.scopus.com/inward/record.url?scp=85079134436&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85079134436&partnerID=8YFLogxK

U2 - 10.1038/s41372-020-0594-4

DO - 10.1038/s41372-020-0594-4

M3 - Article

C2 - 32020038

AN - SCOPUS:85079134436

SN - 0743-8346

VL - 40

SP - 616

EP - 627

JO - Journal of Perinatology

JF - Journal of Perinatology

IS - 4

ER -

Timing of postnatal steroids for bronchopulmonary dysplasia: association with pulmonary and neurodevelopmental outcomes

Abstract

Bibliographical note

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this