Trial reportPediatrics2009
Impact of postnatal corticosteroid use on neurodevelopment at 18 to 22 months' adjusted age: effects of dose, timing, and risk of bronchopulmonary dysplasia in extremely low birth weight infants.
Trial report in Pediatrics, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 47 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Follow-up Visit of High Risk Infants
Randomized Controlled Trial of Benchmarking to Reduce Bronchopulmonary Dysplasia to Reduce Bronchopulmonary Dysplasia
Who cites it
47 citing papers in PubMed, 5 syntheses or guidelines pooled it, 113 citations in OpenAlex.
- Intratracheal instillation of corticosteroids combined with surfactant for preventing chronic lung disease in preterm infants.The Cochrane database of systematic reviews · 2025Pooled it
- Prognostic factors for cerebral palsy and motor impairment in children born very preterm or very low birthweight: a systematic review.Developmental medicine and child neurology · 2016Pooled it
- Glucocorticoids for acute viral bronchiolitis in infants and young children.The Cochrane database of systematic reviews · 2013Pooled it
- Epinephrine for bronchiolitis.The Cochrane database of systematic reviews · 2011Pooled it
- Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2011Pooled it
- Dexamethasone, Prednisolone, and Methylprednisolone Use and 2-Year Neurodevelopmental Outcomes in Extremely Preterm Infants.JAMA network open · 2022Trial
- Lactose-free infant formula does not change outcomes of neonatal abstinence syndrome (NAS): a randomized clinical trial.Journal of perinatology : official journal of the California Perinatal Association · 2021Trial
- Pilot randomized trial of hydrocortisone in ventilator-dependent extremely preterm infants: effects on regional brain volumes.The Journal of pediatrics · 2013Trial
- Role of probiotics in the prevention of the enteric colonization by Candida in preterm newborns: incidence of late-onset sepsis and neurological outcome.Journal of perinatology : official journal of the California Perinatal Association · 2011Trial
- Near-Infrared Laser Photobiomodulation Reduces Pro-Inflammatory Cytokines in an In Vitro Model of Bronchopulmonary Dysplasia: A Preliminary Report.Medical sciences (Basel, Switzerland) · 2026Article
- Systemic corticosteroid use and neurodevelopmental outcomes in preterm infants: a cohort study.World journal of pediatrics : WJP · 2025Article
- Neurodevelopment in Term Infants with Normal Birthweight following Postnatal Systemic Steroid Exposure.Neuroepidemiology · 2024Article
- Impact of postnatal dexamethasone timing on preterm mortality and bronchopulmonary dysplasia: a propensity score analysis.The European respiratory journal · 2023Article
- Systemic postnatal corticosteroid use for the prevention of bronchopulmonary dysplasia and its relationship to early neurodevelopment in extremely preterm infants.World journal of pediatrics : WJP · 2023Article
- Influence of sex on the requirement for and outcomes following late postnatal corticosteroid treatment.European journal of pediatrics · 2023Article
- Timing of Systemic Steroids and Neurodevelopmental Outcomes in Infants < 29 Weeks GestationChildren (Basel, Switzerland) · 2022Article
- Protective Effects of 18β-Glycyrrhetinic Acid on Neonatal Rats with Hyperoxia Exposure.Inflammation · 2022Article
- Pharmacotherapy in Bronchopulmonary Dysplasia: What Is the Evidence?Frontiers in pediatrics · 2022Review
- Neuromotor Development Evaluation of Preterm Babies Less than 34 Weeks of Gestation with Bayley III at 18-24 Months.BioMed research international · 2020Article
- Midterm Neuromotor Development Results of Preterm Babies less than 34 Weeks Gestational Age.Sisli Etfal Hastanesi tip bulteni · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 9 institutions in 1 country.
Funding
Abstract
objectivePostnatal steroid use decreases lung inflammation but increases impairment. We hypothesized that increased dose is associated with increased neurodevelopmental impairment, lower postmenstrual age at exposure increases impairment, and risk of bronchopulmonary dysplasia modifies the effect of postnatal corticosteroid.
methodsSteroid dose and timing of exposure beyond 7 days was assessed among 2358 extremely low birth weight infants nested in a prospective trial, with 1667 (84%) survivors examined at 18 to 22 months' postmenstrual age. Logistic regression tested the relationship between impairment (Bayley Mental Developmental Index/Psychomotor Developmental Index of <70, disabling cerebral palsy, or sensory impairment), total dose (tertiles: <0.9, 0.9-1.9, and >/=1.9 mg/kg), and postmenstrual age at first dose. Separate logistic regression tested effect modification according to bronchopulmonary dysplasia severity (Romagnoli risk > 0.5 as high risk, n = 2336 (99%) for days of life 4-7).
resultsThree hundred sixty-six (16%) neonates were steroid-treated (94% dexamethasone). Treated neonates were smaller and less mature; 72% of those treated were at high risk for bronchopulmonary dysplasia. Exposure was associated with neurodevelopmental impairment/death. Impairment increased with higher dose; 71% dead or impaired at highest dose tertile. Each 1 mg/kg dose was associated with a 2.0-point reduction on the Mental Developmental Index and a 40% risk increase for disabling cerebral palsy. Older age did not mitigate the harm. Treatment after 33 weeks' postmenstrual age was associated with greatest harm despite not receiving the highest dose. The relationship between steroid exposure and impairment was modified by the bronchopulmonary dysplasia risk, with those at highest risk experiencing less harm.
conclusionsHigher steroid dose was associated with increased neurodevelopmental impairment. There is no "safe" window for steroid use in extremely low birth weight infants. Neonates with low bronchopulmonary dysplasia risk should not be exposed. A randomized trial of steroid use in infants at highest risk is warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.