title: Hydrocortisone use in ventilated extremely preterm infants decreased bronchopulmonary dysplasia with no effects on neurodevelopment after two years.
abstract: OBJECTIVE
  We assessed the outcomes of ventilated extremely premature infants treated with late postnatal corticosteroids from 2005-2008, according to permissive or restrictive policies in two centres.
  
  
  METHODS
  This retrospective study included inborn infants below 27 weeks of gestational age who were ventilator dependent after 14 days. Centre P permitted postnatal corticosteroids but centre R restricted their use. The effects on infants were assessed in hospital and after two years using multivariable analysis.
  
  
  RESULTS
  We compared 62 infants from centre P, including 92% who received hydrocortisone, and 48 infants from centre R, including 13% who received betamethasone. Infants from both centres had comparable baseline characteristics and perinatal management, but bronchopulmonary dysplasia (BPD) rates were significantly lower in centre P (30% versus 71%, p < 0.001) and this centre was significantly associated with a younger post-conceptional age at oxygen weaning, with an adjusted hazard ratio (aHR) of 0.45 and an aHR of 0.51at discharge. At two years of corrected age, 18% of centre P infants and 30% of centre R infants showed poor neurodevelopmental outcome (p = 0.18).
  
  
  CONCLUSIONS
  Using hydrocortisone after 14 days on ventilated extremely preterm infants was associated with decreased BPD, with no apparent effects on neurodevelopment at two years of corrected age.
authors.affiliation: Neonatal Intensive Care Unit, CHI Créteil, Créteil, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Renault
authors.affiliation: Neonatal Intensive Care Unit, AP-HP, Maternité Cochin-Port Royal, Paris, France.
authors.forename: Juliana
authors.initials: J
authors.lastname: Patkaï
authors.affiliation: Neonatal Intensive Care Unit, CHI Créteil, Créteil, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Dassieu
authors.affiliation: Neonatal Intensive Care Unit, AP-HP, Maternité Cochin-Port Royal, Paris, France.|Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Inserm UMR 1153, Paris Descartes University, Paris, France.
authors.forename: Mayass
authors.initials: M
authors.lastname: El Ayoubi
authors.affiliation: CEpiA (Clinical Epidemiology And Ageing) Unit EA4393, UPEC, Université Paris-Est, A-TVB DHU, Créteil, France.|Clinical Research Unit (URC Mondor), AP-HP, Hôpital Henri-Mondor, Créteil, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Canouï-Poitrine
authors.affiliation: Neonatal Intensive Care Unit, CHI Créteil, Créteil, France.|Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Inserm UMR 1153, Paris Descartes University, Paris, France.
authors.forename: Xavier
authors.identifier: http://orcid.org/0000-0002-6303-7252
authors.initials: X
authors.lastname: Durrmeyer
mesh_terms: D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D001623:Betamethasone / Q000008:administration & dosage / Q000009:adverse effects; D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control*; D002657:Child Development / Q000187:drug effects*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects*; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D065886:Neurodevelopmental Disorders / Q000139:chemically induced*; D012121:Respiration, Artificial; D012189:Retrospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D001623:Betamethasone; D006854:Hydrocortisone
keywords: Bronchopulmonary dysplasia; Extremely low gestational age; Hydrocortisone; Neurodevelopmental outcome; Postnatal steroids