LONGITUDINAL ASSESSMENT OF GROWTH AND BONE-MINERAL ACCRETION IN PREMATURELY BORN INFANTS TREATED FOR CHRONIC LUNG-DISEASE WITH DEXAMETHASONE

The objective of this study in premature infants was to assess the rel ationship between dexamethasone, growth and bone mineral accretion. Ni ne appropriate size for gestational age premature infants treated for chronic lung disease with tapering doses of dexamethasone (0.5-0.1 mg/ kg/day over 37+/-7 days) were individually matched to a comparison inf ant by sex, gestational age, birth-weight, and type of feed. Infant gr owth and bone mineral accretion were measured at equivalent gestationa l ages from recruitment until 6 months corrected age. During hospitali zation, mean rate of weight, length and head circumference growth and bone mineral accretion in the distal radius were significantly lower i n the dexamethasone-treated infants in spite of similar nutrient intak es. Dexamethasone infants had significantly lower plasma phosphorus, a nd urinary calcium, pyridinoline and N-telopeptide excretion. Dexameth asone affected absolute length, but not weight, throughout the study. No significant differences were observed in body composition or absolu te radial and whole body bone mineral content. The results indicate th at dexamethasone therapy compromises growth and bone mineral accretion in small premature infants. 'Catch-up' linear growth was not evident at 6 months of age and reflects the importance of early nutrition inte rventions. (C) 1997 Elsevier Science Ireland Ltd.