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April 4, 2017

Reevaluating Postnatal Steroids for Extremely Preterm Infants to Prevent Lung Disease

Author Affiliations
  • 1Institute for Women’s Health, University College London, London, England
JAMA. 2017;317(13):1317-1318. doi:10.1001/jama.2017.2725

Compared with the universal acceptance of antenatal steroids as an inexpensive, safe, and highly effective way of enhancing neonatal survival and reducing morbidity in preterm infants, the use of steroids after birth has been more controversial,1 and there remains uncertainty about which steroid to use, indications, safety, and dosage.

Neonatal bronchopulmonary dysplasia or chronic lung disease is the most common neonatal complication following extremely preterm birth (gestational age of <28 weeks) or in extremely low-birth-weight infants (<1000 g), and approximately half of these infants will require supplemental oxygen at 36 weeks of postmenstrual age. Chronic respiratory morbidity remains with the child throughout life. Children with more severe neonatal lung disease have poorer respiratory function in early adolescence2 and are likely also to have respiratory morbidity in adult life.3