Efecto de los esteroides posnatales en el neurodesarrollo en recién nacidos ventilados ≤ de 1,500 g

Introduction

The use of steroids in the post-natal period is a common practice, although it is still controversial in neonatology due to its association with adverse effects and risk of neurodevelopment sequelae.

Material and methods

A retrospective, observational, analytical study was conducted including patients weighing less than 1500 g that received a steroid protocol for extubation between 2008 and 2010 and compared with a control group. Neurodevelopment was evaluated using the Bayley II scale at one and two years of age, as well as an analysis of the demographic variables and morbidity.

Results

A total of 132 patients were included, with 46 in the study group and 86 in the control group. No differences were found in the demographic variables, although the length of stay was significantly longer in the study group. An increased risk for arterial hypertension, grade II intraventricular haemorrhage, Patent Ductus Arteriosus, bronchopulmonary dysplasia, and retinopathy was found in the study group. There was no difference as regards blindness, hearing loss, cerebral palsy, and leukomalacia. At 2 years of age an increase in the risk for mild mental development impairment was found in the control group and increased risk for significant delay in psychomotor development in the study group.

Conclusions

Post-natal low dose steroids are effective to accomplish extubation in patients that are ventilation dependent. Significant psychomotor development changes were found at 2 years of age, with no evidence of leukomalacia or cerebral palsy.