PMID- 28714339
OWN - NLM
STAT- MEDLINE
DCOM- 20181025
LR  - 20181025
IS  - 1476-4954 (Electronic)
IS  - 1476-4954 (Linking)
VI  - 31
IP  - 20
DP  - 2018 Oct
TI  - Inhaled and systemic steroid exposure and neurodevelopmental outcome of preterm 
      neonates.
PG  - 2665-2672
LID - 10.1080/14767058.2017.1350644 [doi]
AB  - OBJECTIVES: To compare death and/or neurodevelopmental outcomes of preterm 
      infants exposed to inhaled and/or systemic steroids with those without exposure, 
      and examine the impact of timing of exposure. METHODS: Retrospective study of 
      infants born <29 weeks gestation and assessed at 18-21 months corrected age (CA). 
      Neurodevelopmental impairment (NDI) was defined as any Bayley Scales of Infant 
      and Toddler Development-III (BSID-III) score <85, cerebral palsy >/= grade one, and 
      visual or hearing impairment. Significant NDI (sNDI) was defined as any Bayley 
      Scales of Infant Development (BSID-III) score <70, cerebral palsy >/= grade three, 
      or severe vision or hearing impairment. RESULTS: Of 2570 neonates, 1811 had no 
      exposure, 125 were exposed to inhaled steroids, 522 to systemic steroids and 112 
      to both. Infants exposed to inhaled steroids had lower odds of bronchopulmonary 
      dysplasia [adjusted odds ratio (AOR) 0.51, (0.33, 0.79)], and displayed no 
      difference in death/NDI or death/significant neurodevelopmental impairment 
      (sNDI), regardless of timing of exposure. Infants only exposed to systemic 
      steroids before 4 weeks of age were at increased odds of death/NDI [AOR 1.83 
      (1.43, 2.34)] and death/sNDI [AOR 2.28 (1.76, 2.96)]. CONCLUSIONS: Exposure to 
      inhaled steroids was not associated with increased odds of death/NDI or 
      death/sNDI. Systemic steroids use before 4 weeks of age was associated with 
      significantly worse outcomes.
FAU - Kelly, Edmond N
AU  - Kelly EN
AD  - a Department of Paediatrics , Mount Sinai Hospital , Toronto , Canada.
AD  - b Department of Paediatrics , University of Toronto , Toronto , Canada.
FAU - Shah, Vibhuti S
AU  - Shah VS
AD  - a Department of Paediatrics , Mount Sinai Hospital , Toronto , Canada.
AD  - b Department of Paediatrics , University of Toronto , Toronto , Canada.
FAU - Levenbach, Jody
AU  - Levenbach J
AD  - a Department of Paediatrics , Mount Sinai Hospital , Toronto , Canada.
FAU - Vincer, Michael
AU  - Vincer M
AD  - c Department of Paediatrics , IWK Health Centre , Halifax , Canada.
FAU - DaSilva, Orlando
AU  - DaSilva O
AD  - d Department of Paediatrics , Western University , London , Canada.
FAU - Shah, Prakesh S
AU  - Shah PS
AD  - a Department of Paediatrics , Mount Sinai Hospital , Toronto , Canada.
AD  - b Department of Paediatrics , University of Toronto , Toronto , Canada.
CN  - Canadian Neonatal Network and Canadian Neonatal Follow-Up Network Investigators
LA  - eng
PT  - Journal Article
DEP - 20170716
PL  - England
TA  - J Matern Fetal Neonatal Med
JT  - The journal of maternal-fetal & neonatal medicine : the official journal of the 
      European Association of Perinatal Medicine, the Federation of Asia and Oceania 
      Perinatal Societies, the International Society of Perinatal Obstetricians
JID - 101136916
RN  - 0 (Adrenal Cortex Hormones)
SB  - IM
MH  - Administration, Inhalation
MH  - Adrenal Cortex Hormones/*administration & dosage/*adverse effects
MH  - Bronchopulmonary Dysplasia/*drug therapy/mortality
MH  - Canada/epidemiology
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Infant, Premature
MH  - Male
MH  - Neurodevelopmental Disorders/*chemically induced
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Bronchopulmonary dysplasia
OT  - mortality
OT  - neonates
OT  - neurodevelopmental outcomes
OT  - prematurity
OT  - steroids
EDAT- 2017/07/18 06:00
MHDA- 2018/10/26 06:00
CRDT- 2017/07/18 06:00
PHST- 2017/07/18 06:00 [pubmed]
PHST- 2018/10/26 06:00 [medline]
PHST- 2017/07/18 06:00 [entrez]
AID - 10.1080/14767058.2017.1350644 [doi]
PST - ppublish
SO  - J Matern Fetal Neonatal Med. 2018 Oct;31(20):2665-2672. doi: 
      10.1080/14767058.2017.1350644. Epub 2017 Jul 16.