title: Randomised trial of early neonatal hydrocortisone demonstrates potential undesired effects on neurodevelopment at preschool age.
abstract: OBJECTIVE
  We evaluated the neurodevelopment and growth of five- to seven-year-old children who had participated in a randomised trial of early low-dose hydrocortisone treatment to prevent bronchopulmonary dysplasia.
  
  
  METHODS
  The 51 infants in the original study had birthweights of 501-1250 g and gestational ages of 23-30 weeks, required mechanical ventilation during the first 24 hours and received hydrocortisone or a placebo for 10 days. The majority (80%) of the 90% who survived to five- to seven years of age participated in this follow-up study and their growth, neuromotor, cognitive and speech development were evaluated.
  
  
  RESULTS
  Some neurodevelopment impairment was observed in 61% of the hydrocortisone group and 39% of the placebo group, ranging from minor neurological dysfunction to severe neurological conditions (p = 0.182). The mean full-scale intelligence quotient (IQ) was 87.8 (15.3) in the hydrocortisone group and 95.7 (15.0) in the placebo group (p = 0.135), and the mean performance IQ was 88.3 (14.5) and 99.1 (14.0) (p = 0.034), respectively. A fifth (22%) of the hydrocortisone group required physiotherapy, but none of the placebo group did (p = 0.034). The age-standardised growth was comparable between both groups.
  
  
  CONCLUSIONS
  Early hydrocortisone treatment may have undesired effects on neurodevelopment at preschool age, and further safety studies are required.
authors.affiliation: PEDEGO Research Center, and Medical Research Center Oulu, University of Oulu, Oulu, Finland.|Department of Paediatrics and Adolescence, Oulu University Hospital, Oulu, Finland.
authors.forename: Outi M
authors.initials: OM
authors.lastname: Peltoniemi
authors.affiliation: Hospital of Children and Adolescents, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Aulikki
authors.initials: A
authors.lastname: Lano
authors.affiliation: Faculty of Humanities, Logopedics, University of Oulu, Oulu, Finland.
authors.forename: Anneli
authors.initials: A
authors.lastname: Yliherva
authors.affiliation: Hospital of Children and Adolescents, Helsinki University Hospital, Helsinki, Finland.
authors.forename: M Anneli
authors.initials: MA
authors.lastname: Kari
authors.affiliation: PEDEGO Research Center, and Medical Research Center Oulu, University of Oulu, Oulu, Finland.|Department of Paediatrics and Adolescence, Oulu University Hospital, Oulu, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Hallman
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control; D002648:Child; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D003071:Cognition / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006128:Growth / Q000187:drug effects*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000009:adverse effects*; D007231:Infant, Newborn; D007360:Intelligence; D008297:Male; D013060:Speech / Q000187:drug effects
chemical_list: D006854:Hydrocortisone
keywords: Cerebral palsy; Growth; Hydrocortisone; Neurodevelopment; Post-natal corticosteroids