Differences in behavioral outcome and motor development at school age after neonatal treatment for chronic lung disease with dexamethasone versus hydrocortisone.
Neonatal dexamethasone (DEX) for chronic lung disease is associated with adverse outcome. We compared behavioral and motor development at school age of children who neonatally received DEX to children neonatally treated with hydrocortisone (HC) in a retrospective matched cohort study. DEX- and HC-treated groups matched for gestational age, birth weight and year, gender, and severity of respiratory distress syndrome were compared with a reference group (REF) and a group treated only antenatally with betamethasone (BMETH). REF and BMETH groups had a higher gestational age and less severe respiratory distress syndrome. From 192 children (DEX, n = 46; HC, n = 52; REF, n = 43; BMETH, n = 51), the Child Behavioral Checklists from parents and teachers (Teacher's Report Form) and the Movement Assessment Battery for Children to assess neuromotor function were analyzed. DEX girls had a poorer performance on nearly all behavioral scales of the Teacher's Report Form compared with HC girls. DEX boys did not differ from HC boys. The HC boys or girls did not differ from the REF or BMETH groups. Neuromotor development was poorer in DEX than the BMETH and REF groups. The HC group did not differ from REF and BMETH groups. We suggest that neonatal HC may be a "safer" alternative for DEX for the treatment of CLD.
Karemaker
Rosa
R
Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, 3508 AB Utrecht, the Netherlands.
Heijnen
Cobi J
CJ
Veen
Sylvia
S
Baerts
Wim
W
Samsom
Janny
J
Visser
Gerard H A
GH
Kavelaars
Annemieke
A
van Doornen
Lorenz J P
LJ
van Bel
Frank
F
D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002652:Child Behavior / Q000187:drug effects* / Q000502:physiology; D002657:Child Development / Q000187:drug effects / Q000502:physiology; D002908:Chronic Disease; D015331:Cohort Studies; D003907:Dexamethasone / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D007231:Infant, Newborn; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000503:physiopathology; D009043:Motor Activity / Q000187:drug effects* / Q000502:physiology; D019957:Motor Skills Disorders / Q000209:etiology / Q000503:physiopathology; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D003907:Dexamethasone; D006854:Hydrocortisone