Engelsk titel: Use and misuse of steroids to newborn
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Författare:
Stördal K
;
Lunde J
Email: ketil.stordal@c2i.net
Språk: Nor
Antal referenser: 50
Dokumenttyp:
Översikt
UI-nummer: 07111714
Sammanfattning
BACKGROUND : A growing number of extremely preterm neonates survive; a high percentage develop chronic lung disease/bronchopulmonal dysplasia. The short-term effect of glucocorticoids in prevention or treatment is beneficial, but short- and long-term side effects are of concern.
METHODS : Based on non-systematic searches in the Medline and Cochrane databases, this article provides an overview of beneficial and detrimental effects (emphasis on long-term side effects) of glucocorticoids in the neonatal period.
RESULTS AND INTERPRETATION : Steroids have a beneficial short-term effect on bronchopulmonal dysplasia, with reduced duration of ventilator treatment and decreased needs for oxygen supplementation at 36 weeks gestational age (odds ratio 0.62-0.76). However, survival at 40 weeks is not improved due to severe side effects. Long-term effects on neurodevelopmental outcome show a significant increase in the risk for cerebral palsy (odds ratio 1.69) and a significant increase in the risk for abnormal neurological development and cognitive impairment of equal size. No significant effects on lung function, growth and metabolic outcome later in childhood have been proven so far. Given that glucocorticoids do not increase survival of neonates, their serious side effects indicate that they should only be considered with severe ventilator-dependent lung disease after 2-3 weeks.