title: Functional outcome at school age of preterm-born children treated with high-dose dexamethasone.
abstract: BACKGROUND
  Postnatal dexamethasone (DXM) treatment is associated with adverse motor outcome. It is largely unknown as to what extent functional outcome at school age is affected.
  
  
  OBJECTIVE
  Our first aim was to determine motor, cognitive, and behavioural outcome at school age of preterm-born children treated with high-dose DXM for pulmonary problems. Our second aim was to identify DXM-related risk factors for adverse outcome.
  
  
  METHODS
  In this cohort study, we included 53 very preterm-born children treated with DXM (starting dose 0.5mg/kg/d) after the first week of life. At the median age of 9 years, we performed a detailed neuropsychological assessment.
  
  
  RESULTS
  Compared to the norm population, DXM-treated children scored worse on the Movement-ABC (abnormal fine motor, ball skills and balance: 59%, 47% and 30%, respectively). They more often had total (36%), verbal (32%) and performance IQs (55%) below 85 (P<.001, P=.002, P<.001, respectively). On each of the remaining measures, DXM-treated children scored worse than the norm population, except for verbal long-term memory and verbal recognition memory. DXM-related risk factors were associated with poorer performance.
  
  
  CONCLUSIONS
  At school age, multiple domains of functional outcome were affected in DXM-treated children. Risk factors related to the use of DXM should be considered as serious potentiaters of adverse outcome in children treated with high-dose DXM.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: m.m.hitzert@umcg.nl.
authors.forename: Marrit M
authors.initials: MM
authors.lastname: Hitzert
authors.affiliation: Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Koenraad N J A
authors.initials: KN
authors.lastname: Van Braeckel
authors.affiliation: Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Marijn
authors.initials: M
authors.lastname: de Bok
authors.affiliation: Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Carel G B
authors.initials: CG
authors.lastname: Maathuis
authors.affiliation: Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Elise
authors.initials: E
authors.lastname: Roze
authors.affiliation: Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Arend F
authors.initials: AF
authors.lastname: Bos
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy; D002648:Child; D002652:Child Behavior / Q000187:drug effects*; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000139:chemically induced / Q000453:epidemiology; D015331:Cohort Studies; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use*; D056344:Executive Function / Q000187:drug effects; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D057567:Memory, Long-Term / Q000187:drug effects; D009048:Motor Skills / Q000187:drug effects*; D009483:Neuropsychological Tests; D047928:Premature Birth; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Behaviour; Bronchopulmonary dysplasia; Cognition; Dexamethasone; Motor function