Minor neurological dysfunction, cognitive development, and somatic development at the age of 3 to 7 years after dexamethasone treatment in very-low birth-weight infants.
The objective of this study was to assess minor neurological dysfunction, cognitive development, and somatic development after dexamethasone therapy in very-low-birthweight infants. Thirty-three children after dexamethasone treatment were matched to 33 children without dexamethasone treatment. Data were assessed at the age of 3-7 years. Dexamethasone was started between the 7th and the 28th day of life over 7 days with a total dose of 2.35 mg/kg/day. Exclusion criteria were asphyxia, malformations, major surgical interventions, small for gestational age, intraventricular haemorrhage grades III and IV, periventricular leukomalacia, and severe psychomotor retardation. Each child was examined by a neuropediatrician for minor neurological dysfunctions and tested by a psychologist for cognitive development with a Kaufman Assessment Battery for Children and a Draw-a-Man Test. There were no differences in demographic data, growth, and socio-economic status between the two groups. Fine motor skills and gross motor function were significantly better in the control group (p<0.01). In the Draw-a-Man Test, the control group showed better results (p<0.001). There were no differences in development of speech, social development, and the Kaufman Assessment Battery for Children. After dexamethasone treatment, children showed a higher rate of minor neurological dysfunctions. Neurological development was affected even without neurological diagnosis. Further long-term follow-up studies will be necessary to fully evaluate the impact of dexamethasone on neurological and cognitive development.
Kutschera
J
J
Department of Paediatrics, University Hospital, Auenbruggerplatz 30, Graz A-8036, Austria. joerg.kutschera@klinikum-graz.at
Tomaselli
J
J
Maurer
U
U
Mueller
W
W
Urlesberger
B
B
D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology* / Q000523:psychology; D008297:Male; D009422:Nervous System Diseases / Q000139:chemically induced*; D012189:Retrospective Studies
D005938:Glucocorticoids; D003907:Dexamethasone