Effect on growth of two different dexamethasone courses for preterm infants at risk of chronic lung disease - A randomized trial

A randomized study was designed to evaluate the effects of two different de xamethasone courses on the growth of preterm infants. The first phase inclu ded 30 preterm infants at high risk for chronic lung disease (CLD). 15 babi es (moderately early dexamethasone group) were treated with dexamethasone f or 14 days, from the 10th day of life, and received a total dose of 4.75 mg /kg; 15 babies were assigned to the control group. The second phase include d 30 preterm infants at high risk for CLD. 15 babies (early dexamethasone g roup) were treated with dexamethasone for 7 days, from the 4th day of life, and received a total dose of 2.38 mg/kg; 15 babies were assigned to the co ntrol group. All the main clinical baseline characteristics were similar be tween the groups both in the first and in the second phase. Infants given t he two dexamethasone courses showed significantly reduced weight gain durin g the period of treatment when compared to the respective control group, bu t they had a weight catch-up soon after the end of treatment. At 30 days of life the weight and length gain of each treated group were similar to thos e of control infants, but the moderately early dexamethasone group showed a significantly poorer head growth. No differences between the groups were o bserved at discharge. Dexamethasone treatment induces a slower weight gain which is time-limited to the period of treatment and is followed by a body weight catch-up. However, the poorer head growth detected at 30 days of lif e in the infants who received a higher dose of dexamethasone could indicate important adverse effects, possibly dose-related, on postnatal brain growt h and development.