Postnatal corticosteroids and the brain

摘要

Systemic postnatal corticosteroid therapy in ventilator-dependent infants reduces both ventilator and oxygen dependency. Controversy exists, however, about its effects on long-term survival free of neurosensory impairments and disabilities There are some follow-up data from 19 randomized controlled trials that recruited a total of 1698 infants. The rate of cerebral palsy in the survivors assessed is significantly higher in treated infants, predominantly when corticosteroids are started in the first week of life. However, the rates of survival free of cerebral palsy of major neurosensory disability and of survival free of major disability are not significantly higher in corticosteroid-treated children. The early use of corticosteroids may cause an increase in cerebral palsy but with a negligible effect on the rate of survival free of major disability.There is little evidence that the therapeutic use of corticosteroids after the first week of life causes any substantial long-term harm or benefit, but better evidence is required.