title: Association between postnatal dexamethasone for treatment of bronchopulmonary dysplasia and brain volumes at adolescence in infants born very preterm.
abstract: OBJECTIVE
  To compare brain volumes in adolescents who were born extremely preterm (<28 weeks gestation) who had received postnatal dexamethasone, and to determine if there was a postnatal dexamethasone dose-response effect on brain volumes.
  
  
  METHODS
  Geographical cohort study of extremely preterm adolescents born in 1991-1992 in Victoria, Australia. T1-weighted magnetic resonance imaging was performed at 18 years of age. Segmented and parcellated brain volumes were calculated using an automated segmentation method (FreeSurfer) and compared between groups, with and without adjustment for potential confounders. The relationships between total postnatal dexamethasone dose and brain volumes were explored using linear regression.
  
  
  RESULTS
  Of the 148 extremely preterm participants, 55 (37%) had received postnatal dexamethasone, with a cumulative mean dose of 7.7 mg/kg. Compared with participants who did not receive postnatal dexamethasone, those who did had smaller total brain tissue volumes (mean difference -3.6%, 95% CI [-7.0%, -0.3%], P value = .04) and smaller white matter, thalami, and basal ganglia volumes (all P < .05). There was a trend of smaller total brain and white matter volumes with increasing dose of postnatal dexamethasone (regression coefficient -7.7 [95% CI -16.2, 0.8] and -3.2 [-6.6, 0.2], respectively).
  
  
  CONCLUSIONS
  Extremely preterm adolescents who received postnatal dexamethasone in the newborn period had smaller total brain tissue volumes than those who did not receive postnatal dexamethasone, particularly white matter, thalami, and basal ganglia. Vulnerability of brain tissues or structures associated with postnatal dexamethasone varies by structure and persists into adolescence.
authors: Neonatal Services, Royal Women's Hospital, Melbourne, Australia; Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Australia. Electronic address: jeanie.cheong@thewomens.org.au.
authors: Jeanie L Y
authors: JL
authors: Cheong
authors: Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Melbourne, Australia.
authors: Alice C
authors: AC
authors: Burnett
authors: Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; Clinical Epidemiology and Biostatistics, Murdoch Childrens Research Institute, Melbourne, Australia.
authors: Katherine J
authors: KJ
authors: Lee
authors: Department of Pediatrics, University of Melbourne, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia.
authors: Gehan
authors: G
authors: Roberts
authors: Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Melbourne, Australia; Developmental Imaging, Murdoch Childrens Research Institute, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.
authors: Deanne K
authors: DK
authors: Thompson
authors: School of Psychology, University of Birmingham, Edgbaston, United Kingdom.
authors: Stephen J
authors: SJ
authors: Wood
authors: Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.
authors: Alan
authors: A
authors: Connelly
authors: Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia.
authors: Peter J
authors: PJ
authors: Anderson
authors: Neonatal Services, Royal Women's Hospital, Melbourne, Australia; Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Australia.
authors: Lex W
authors: LW
authors: Doyle
mesh_terms: D000293:Adolescent; D001921:Brain / Q000187:drug effects* / Q000254:growth & development*; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy*; D015331:Cohort Studies; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009929:Organ Size
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone