title: Steroids and injury to the developing brain: net harm or net benefit?
abstract: Deleterious effects result from both glucocorticoid insufficiency and excess glucocorticoid tissue exposure in the developing brain. Accumulating evidence suggests a net benefit of postnatal glucocorticoid therapy when administered shortly after the first week of life to premature infants with early and persistent pulmonary dysfunction, particularly in those with evidence of relative adrenal insufficiency. The decision to treat with steroids should ensure maximum respiratory benefit at the lowest possible neurologic risk, while avoiding serious systemic complications. Ongoing clinical trials must validate this approach.
authors: Department of Pediatrics, St. Christopher's Hospital for Children, Drexel University College of Medicine, 245 North 15th Street, New College Building, Room 7410, Mail Stop 1029, Philadelphia, PA 19102, USA. Electronic address: Shadi.Malaeb@drexelmed.edu.
authors: Shadi N
authors: SN
authors: Malaeb
authors: Department of Pediatrics, Women & Infants Hospital of Rhode Island, The Alpert Medical School of Brown University, 101 Dudley Street, Providence, RI 02905, USA.
authors: Barbara S
authors: BS
authors: Stonestreet
mesh_terms: D001921:Brain / Q000187:drug effects / Q000254:growth & development*; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D011247:Pregnancy; D013997:Time Factors
chemical_list: D005938:Glucocorticoids; D018696:Neuroprotective Agents
keywords: Brain injury; Cerebral palsy; Controversy; Development; Glucocorticoids; Infant; Outcomes; Premature infant