title: Hydrocortisone and long-term outcomes in very-low-birthweight infants.
abstract: BACKGROUND
  The long-term effects of hydrocortisone (HDC) used for very-low-birthweight (VLBW) infants with chronic lung disease (CLD) are not fully understood. The aim of this study was to examine the short-term clinical effects and long-term impact of a physiological replacement dose of HDC on acute deterioration of CLD in VLBW infants.
  
  
  METHODS
  This prospective case-control study included 110 of the 174 VLBW infants admitted to our facility between 2003 and 2006 who were followed up to a corrected age of 18 months. Infant deaths and infants with congenital deformities were excluded from the study. The infants were classified into the following three groups: infants with CLD and treated with HDC (1-2 mg/kg/dose) due to progressive deterioration in oxygenation (CLD treatment group; n = 24); infants with CLD but not treated with HDC (CLD untreated group; n = 40); and infants without CLD (non-CLD group; n = 46).
  
  
  RESULTS
  The fraction of inspired oxygen (F(I) O(2) ) in the CLD treatment group improved significantly after treatment (P < 0.01). There were no significant differences among the three groups in terms of growth and neurodevelopmental quotient at the corrected age of 18 months following adjustment for birthweight, sex, and presence of light-for-date infants. There were also no significant intergroup differences in all three areas of developmental quotient.
  
  
  CONCLUSIONS
  Physiological doses of HDC replacement are effective in treating acute deterioration in oxygenation in VLBW infants with CLD. Furthermore, this treatment modality did not adversely affect the growth and development of infants at the corrected age of 18 months.
authors.affiliation: Department of Neonatology, Maternal, and Perinatal Center, Tokyo Women's Medical University, Tokyo, Japan. chikafuku@nyc.odn.ne.jp
authors.forename: Chika
authors.initials: C
authors.lastname: Yamasaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Uchiyama
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Nakanishi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Masumoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Aoyagi
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Washio
authors.forename: Satsuki
authors.initials: S
authors.lastname: Totsu
authors.forename: Ken
authors.initials: K
authors.lastname: Imai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kusuda
mesh_terms: D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D019102:Infant, Very Low Birth Weight; D008171:Lung Diseases / Q000188:drug therapy*; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006854:Hydrocortisone