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

o benefit to the earlier steroid treatment: there was no difference in the number of days that it took the babies in the two groups to breathe without a ventilator. Both groups of babies breathed unassisted at an average of 36 days. The two groups also had a similar frequency of chronic lung disease: 66% in the babies treated with dexamethasone at two weeks and 67% in the group treated at four weeks.

More worrisome was the effect on infections and growth. The infants who were treated with dexamethasone at two weeks of age had an infection rate that was 50% higher than the infants who received placebo at two weeks of age. Moreover, both groups of infants gained weight more slowly and had slower head growth while they received dexamethasone. The authors questioned whether current dexamethasone regimens in premature infants who require ventilator support are potentially more harmful than beneficial.

"Additional randomized trials using lower steroid doses or shorter courses and long-term follow-up are needed to determine if steroid treatment is really beneficial," said Linda Wright, M.D., a study author and investigator from the NICHD.

Others authors of the paper were Lu-Ann Papile, M.D., University of New Mexico, Albuquerque; Jon E. Tyson, M.D., University of Texas Southwestern Medical Center; Barbara J. Stoll, M.D. Emory University; Edward F. Donovan, the University of Cincinnati; Charles R. Bauer, M.D., University of Miami; Heidi Krause-Steinrauf, M.S. and Joel Verter, Ph.D., George Washington University Biostatistics Center; Sheldon B. Korones, M.D., University of Tennessee at Memphis; James A. Lemons, M.D., Indiana University; Avroy A. Fanaroff, M.B, B.Ch, Case Western Reserve University; David K. Stevenson, M.D., Stanford University; William Oh, M.D., Women and Infants Hospital, Brown University; Richard A. Ehrenkranz, M.D., Yale University; and Seetha Shankaran, M.D., Wayne State University.


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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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