DEXAMETHASONE TREATMENT IN PRETERM INFANTS AT RISK FOR BRONCHOPULMONARY DYSPLASIA

A randomised double blind placebo controlled study was conducted to de termine whether a one week course of dexamethasone could reduce the se verity of bronchopulmonary dysplasia in preterm infants without compro mising their adrenal function. Forty one infants with a mean birth wei ght of 880 g and a gestational age of 27 weeks who were ventilator dep endent at 10 days of age were enrolled. At the age of 28 days pulmonar y outcome was significantly better in the girls treated with dexametha sone but not in all infants. There was no difference between the group s in the long term outcome, except for a shorter duration of supplemen tal oxygen in dexamethasone treated female infants. After the one week dexamethasone treatment there was a significant but short lived suppr ession of the basal cortisol concentrations and the adrenal response t o corticotrophin (ACTH). No serious side effects were observed. It is concluded that early one week dexamethasone treatment improves short t erm pulmonary outcome in premature infants, but there is no clear evid ence of long term benefits.