GROWTH AND GROWTH-FACTORS IN PREMATURE-INFANTS RECEIVING DEXAMETHASONE FOR BRONCHOPULMONARY DYSPLASIA

Physical growth and the serum growth factors, insulin growth factor 1 (IGF1) and its binding protein (IGFBP3) were measured weekly during de xamethasone treatment and for 3 weeks after stopping therapy in 10 ven tilated babies [median (range) birth weight 860 g (640-1210); median ( range) gestational age 26 weeks (24-29)] with bronchopulmonary dysplas ia (BPD). The mean (+/-SE) rates of change of all physical measures ex cept crown-rump length (CRL) increased significantly after stopping de xamethasone: weight gain 13.2 (+/-1.5) on versus 30.0 (+/-1.9) g/day o ff treatment; occipital-frontal circumference 0.7 (+/-0.1) versus 1.0 (+/-0.1) cm/week; total body length (TBL) 0.7 (+/-0.1) versus 1.1 (+/- 0.1) cm/week; CRL 0.5 (+/-0.1) versus 0.7 (+/-0.1) cm/week, and knee-a nkle length (KAL) 0.13 (+/-0.02) versus 0.36 (+/-0.04) cm/week. Mean s erum IGF-1 (1.57+/-0.13 versus 3.56+/-0.41 nmol/L) and IGFBP3 (0.94+/- 0.03 versus 1.12 +/- 0.05 mg/L) levels also increased off treatment. T he weekly dose of dexamethasone (mg/kg) was significantly negatively c orrelated with all physical growth measures (P<0.01), but showed no co rrelation with growth factors. Protein intake (g/kg/day) was significa ntly correlated (P<0.01) with weight gain (r = 0.28), changes in TBL ( r = 0.32), serum IGF1 levels (r = 0.60), and IGFBP3 levels (r = 0.37). All aspects of physical growth are compromised during dexamethasone t reatment for BPD. Poor growth during steroid treatment is associated w ith lower IGF1 and ICFBP3 levels. Further study is needed to examine t he effect of varying dexamethasone dosage regimes and nutritional inta ke on the growth process in BPD.