Early dexamethasone therapy and blood cell count in preterm infants

Objective. To assess the effects of early postnatal dexamethasone therapy o n hematologic values in preterm infants. Materials and Methods. We reviewed the hematologic data of 179 preterm infa nts who participated in a double-blind clinical trial of early postnatal de xamethasone therapy (< 12 hours after birth) for the prevention of chronic lung disease. One group (86 infants) received saline and the other group (9 3 infants) received dexamethasone. Dexamethasone was given intravenously ev ery 12 hours in tapering doses: 0.25 mg/kg on days 1 to 7, 0.12 mg/kg on da ys 8 to 14, 0.05 mg/kg on days 15 to 21, and 0.02 mg/kg on days 21 to 28. B lood samples were obtained on days 0, 3, 7, 10, 14, 21, and 28. None of the infants received prenatal steroid therapy. Results. Multiple regression analysis revealed significant differences in t he values versus time curves of the white blood cell, neutrophil, lymphocyt e, basophil, and eosinophil counts between the two groups. The white blood cell count was significantly higher in the dexamethasone group on days 7 th rough 14, and this was associated with significantly higher numbers of segm ented neutrophils and band forms and significantly lower numbers of lymphoc ytes and eosinophils. The hematocrit and platelet counts were similar in th e two groups throughout most of the trial. Except for platelet count, stero id therapy did not alter the hematologic values for infants with bacteremia . Conclusion. Dexamethasone affects white blood cell, segmented neutrophil, l ymphocyte, basophil, and eosinophil counts in neonates. This should be take n into consideration when evaluating preterm infants who are receiving dexa methasone.