title: Postnatal steroids in extremely low birth weight infants: betamethasone or hydrocortisone?
abstract: OBJECTIVE
  To compare the efficacy and tolerance of betamethasone (BTM) and hydrocortisone (HC) in weaning extremely low birth weight (ELBW) infants with bronchopulmonary dysplasia (BPD) from the ventilator.
  
  
  METHODS
  Monocentric, retrospective, cohort analysis based on prospective, standardized collection of data between 2005 and 2011 in ELBW receiving postnatal steroids (PS) after the second week of life. We used BTM for the first 4 years, and thereafter HC. We compared extubation rates, growth, glycaemia and blood pressure.
  
  
  RESULTS
  Sixty-seven infants received PS: 35 BTM and 32 HC. Most infants (83% BTM vs. 72% HC) were extubated during treatment (p = 0.281). During PS, the need for insulin was similar. Mean arterial blood pressure was similar at day 3 of PS, but was significantly lower in infants treated by BTM 30 days after the end of treatment. The z-scores for body weight and head circumference indicated significantly greater loss in BTM than HC group. This persisted only for body weight after adjustment for differences in energy intake and corticosteroid dose.
  
  
  CONCLUSIONS
  Our study suggests that HC may be as efficient as BTM in facilitating the extubation of ELBW infants, without short-term adverse effects. Blood pressure monitoring and investigation of long-term neurodevelopment are nevertheless needed.
authors.affiliation: Neonatology, University Hospital Croix Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ben Said
authors.forename: Stéphane
authors.initials: S
authors.lastname: Hays
authors.forename: Claire-Marie
authors.initials: CM
authors.lastname: Loys
authors.forename: Ludivine
authors.initials: L
authors.lastname: Coletto
authors.forename: Isabelle
authors.initials: I
authors.lastname: Godbert
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Picaud
mesh_terms: D058109:Airway Management / Q000706:statistics & numerical data; D001623:Betamethasone / Q000627:therapeutic use*; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies
chemical_list: D005938:Glucocorticoids; D001623:Betamethasone; D006854:Hydrocortisone