[Perinatal glucocorticosteroid therapy: time for reconsideration].
Glucocorticosteroids are administered antenatally and postnatally to decrease pulmonary morbidity of preterm neonates. One course of antenatal corticosteroids decreases mortality, and the frequency of respiratory distress syndrome and intraventricular hemorrhage. However, multiple courses may be associated with impaired brain development. Follow-up studies are needed to assess long-term consequences. The use of betamethasone may be of advantage compared to dexamethasone. Postnatally, steroids are given to treat or prevent bronchopulmonary dysplasia (BPD). However, recent studies have shown that treatment with dexamethasone increases the rate of cerebral palsy in preterm infants. Postnatal treatment of BPD with steroids should be restricted to life-threatening situations.
Groneck
P
P
Neonatologie und pädiatrische Intensivmedizin, Kliniken der Stadt Köln, Kinderkrankenhaus, Köln, Germany.
D001623:Betamethasone / Q000008:administration & dosage / Q000009:adverse effects; D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control; D002547:Cerebral Palsy / Q000139:chemically induced; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005325:Fetal Organ Maturity / Q000187:drug effects*; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000196:embryology*; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control*; D012307:Risk Factors
D005938:Glucocorticoids; D003907:Dexamethasone; D001623:Betamethasone