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Study Questions Common Practice Of Steroid Administration To Induce Lung Development In Premature Infants

A new study conducted by researchers in the National Institute of Child Health and Human Development (NICHD) Neonatal Research Network suggests that the steroid dexamethasone, which is commonly prescribed to help premature infants get off mechanical ventilators, may have serious side effects.

The study, which was published in the April 16 issue of the New England Journal of Medicine, was an attempt to learn if earlier treatment of ventilator-dependent premature infants with the drug dexamethasone is beneficial. The investigators enrolled 371 very-low-birth-weight infants who weighed between 1 and 3 pounds from 12 centers of the NICHD Neonatal Research Network. The infants were 13 to 15 days old and were on mechanical ventilators because they were unable to breathe on their own. Because ventilator therapy can cause serious long-term problems such as chronic lung disease, neonatologists try to wean infants from ventilators as soon as possible.

Dexamethasone is a therapy that neonatologists use because it improves the function of premature infants' lungs so that they get off the ventilator earlier. Although steroids have been used to treat ventilator-dependent premature infants who were developing chronic lung disease at one month of age, recently they have been used much earlier in an attempt to prevent chronic lung disease.

The trial tested whether giving the drug to premature infants on a ventilator at two weeks of age was more effective than waiting until four weeks of age. Babies were randomized to one of two groups: the first group started a two-week course of dexamethasone treatment immediately while the second group received a placebo. After the initial two-week treatment period the treatments were switched: babies in group one received placebo for two weeks and babies in group two who were still on the ventilator received a two-week course of dexamethasone.

The researchers found that there was n
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Contact: Robin Peth-Pierce
piercer@hd03.nichd.nih.gov
301-496-5133
NIH/National Institute of Child Health and Human Development
15-Apr-1998


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