Hydrocortisone vs. dexamethasone treatment for bronchopulmonary dysplasia and their effects on general movements in preterm infants

Pediatr Res. 2012 Jan;71(1):100-6. doi: 10.1038/pr.2011.15.

Abstract

Introduction: Hydrocortisone (HC) and dexamethasone (DXM) are used to treat preterm infants at risk for bronchopulmonary dysplasia (BPD). This may, however, affect their long-term neurological development. We aimed to determine the effect of HC and DXM therapy in preterm infants on neurological functioning as assessed by the quality of general movements (GMs) until 3 months after term.

Results: We found no difference in the quality of GMs between HC and DXM infants until term age. At 3 months, HC infants had a higher median motor optimality score (MOS) than DXM infants (25 vs. 21, P = 0.015). In the DXM group, MOS on the first day of treatment was lower than before treatment (10 vs. 11, P = 0.030).

Discussion: MOS decreased in DXM infants on the first day following treatment and at 3 months after term. This was not the case in HC infants. Our study suggests that neurological functioning at 3 months after term is better in infants treated with HC than in infants treated with DXM.

Methods: We performed a longitudinal, observational study including 56 preterm infants (n = 17 HC, n = 17 DXM, n = 22 controls). GM quality, videoed before and after treatment, was assessed. In addition, a MOS was assigned to details of the GMs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Bronchopulmonary Dysplasia / drug therapy*
  • Dexamethasone / therapeutic use*
  • Female
  • Gestational Age
  • Humans
  • Hydrocortisone / therapeutic use*
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Premature, Diseases / drug therapy*
  • Longitudinal Studies
  • Male
  • Movement / physiology
  • Movement Disorders / physiopathology

Substances

  • Anti-Inflammatory Agents
  • Dexamethasone
  • Hydrocortisone