Randomized study of the effect of antenatal dexamethasone on growth and development of premature children at the corrected age of 2 years.
The objective of the series was to study the effect of prenatal dexamethasone therapy on the growth and neurological development of preterm children until the age of 2 years. Eighty-two children with a mean gestational age of 30 (24-33) weeks and a mean weight of 1291 (530-2360) g at birth, treated antenatally with either dexamethasone (n = 50) or placebo (n = 32), were examined at the adjusted age of 24 months by a paediatric neurologist, a neuropsychologist and a speech therapist. Neurological development was defined as normal if all scores of neuropaediatric, neuropsychological and verbal tests were within the normal range. Normal neurological development was found in 52% of the dexamethasone-treated and in 34% of the placebo-treated children. The incidence of cerebral palsy was 10% in the dexamethasone group and 22% in the placebo group. Minor developmental delay was found in 42% of dexamethasone-treated and in 53% of placebo-treated children. Our follow-up results indicate that the beneficial effect of prenatal glucocorticoid treatment on cerebral complications (intraventricular haemorrhage or periventricular leucomalacia) demonstrated during the neonatal period may be followed by a lower incidence of cerebral palsy in surviving premature children.
Salokorpi
T
T
Department of Paediatric Neurology, Children's Castle Hospital, Helsinki, Finland.
Sajaniemi
N
N
Hällback
H
H
Kari
A
A
Rita
H
H
von Wendt
L
L
D001927:Brain Diseases / Q000453:epidemiology / Q000517:prevention & control; D002547:Cerebral Palsy / Q000453:epidemiology / Q000517:prevention & control; D002658:Developmental Disabilities / Q000453:epidemiology / Q000517:prevention & control*; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010919:Placebos; D011247:Pregnancy; D011295:Prenatal Care; D012189:Retrospective Studies
D005938:Glucocorticoids; D010919:Placebos; D003907:Dexamethasone