[Postnatal corticosteroid and chronic lung disease]

ABSTRACT

Cortieosteroids can be used postnatally to prevent or treat chronic lung disease. Controversy exists, however, about its effects on long term survival infants. Systematic reviews of randomised controlled trials of postnatal corticosteroids in the Chochrane Library were examined to determine the cost-benefit ratios of treatment. Beneficial effects include earlier extubation, reduced chonic lung disease and avoidance of late steroids. However, there are significant adverse short-term effects such as hyperglycaemia, hypertension, hypertrophic cardiomyopathy, gastrointestinal bleeding and growth failure. More important are long-term adverse effects of cerebral palsy, developmental delay. These adverse effects are more pronounced with early [<96 h] treatment but probably also occur when steroids are given later in the postnatal peroid. Postnatal steroids should be avoided if at all possible. More trials should be undertaken with a long term follow-up