title: Utilization of inhaled corticosteroids for infants with bronchopulmonary dysplasia.
abstract: OBJECTIVE
  To determine demographic and clinical variables associated with inhaled corticosteroid administration and to evaluate between-hospital variation in inhaled steroid use for infants with bronchopulmonary dysplasia (BPD).
  
  
  METHODS
  Retrospective Cohort Study.
  
  
  METHODS
  Neonatal units of 35 US children's hospitals; as recorded in the Pediatric Health Information System (PHIS) database.
  
  
  METHODS
  1429 infants with evolving BPD at 28 days who were born at <29 weeks gestation with birth weight <1500 grams, admitted within the first 7 postnatal days, and discharged between January 2007-June 2011.
  
  
  RESULTS
  Inhaled steroids were prescribed to 25% (n = 352) of the cohort with use steadily increasing during the first two months of hospitalization. The most frequently prescribed steroid was beclomethasone (n = 194, 14%), followed by budesonide (n = 125, 9%), and then fluticasone (n = 90, 6%). Birth gestation <24 weeks, birth weight 500-999 grams, and prolonged ventilation all increased the adjusted odds of ever receiving inhaled corticosteroids (p<0.05). Wide variations between hospitals in the frequency of infants ever receiving inhaled steroids (range: 0-60%) and the specific drug prescribed were noted. This variation persisted, even after controlling for observed confounders.
  
  
  CONCLUSIONS
  Inhaled corticosteroid administration to infants with BPD is common in neonatal units within U.S. Children's hospitals. However, its utilization varies markedly between centers from no treatment at some institutions to the majority of infants with BPD being treated at others. This supports the need for further research to identify the benefits and potential risks of inhaled steroid usage in infants with BPD.
authors.affiliation: The Department of Pediatrics, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, Ohio, United States of America; Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Slaughter
authors.affiliation: The Department of Pediatrics, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, Ohio, United States of America; Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Stenger
authors.affiliation: Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America; The Department of Economics, The Ohio State University, Columbus, Ohio, United States of America; Center for Human Resource Research, The Ohio State University, Columbus, Ohio, United States of America.
authors.forename: Patricia B
authors.initials: PB
authors.lastname: Reagan
authors.affiliation: The Department of Pediatrics, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, Ohio, United States of America; Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America; The Neonatal and Infant Feeding Disorders Research Program, Nationwide Children's Hospital, Columbus, Ohio, United States of America.
authors.forename: Sudarshan R
authors.initials: SR
authors.lastname: Jadcherla
mesh_terms: D000280:Administration, Inhalation; D001507:Beclomethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy*; D019819:Budesonide / Q000008:administration & dosage* / Q000627:therapeutic use; D000068298:Fluticasone / Q000008:administration & dosage* / Q000627:therapeutic use; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007297:Inpatients; D012189:Retrospective Studies
chemical_list: D005938:Glucocorticoids; D019819:Budesonide; D000068298:Fluticasone; D001507:Beclomethasone