GROWTH-HORMONE DOES NOT PREVENT CATABOLIC SIDE-EFFECTS OF DEXAMETHASONE IN EXTREMELY LOW-BIRTH-WEIGHT PRETERM INFANTS WITH BRONCHOPULMONARYDYSPLASIA - A PILOT-STUDY

Recombinant human growth hormone (rhGH) may reduce the catabolic side effects of steroid therapies on children and adults, but this has neve r been studied in preterm infants, We performed a pilot study on 5 ext remely low birth weight preterm infants (gestational age 27 +/- 3 wks, birth weight 824 +/- 160 g) still on mechanical ventilation for bronc hopulmonary dysplasia at the postnatal age of 35 +/- 9 days. All were treated for 7 days with dexamethasone (0.5 mg/kg/d iv) and subcutaneou s rhGH at different doses: 0.1 (n = 1), 0.2 (n = 2) or 0.3 (n = 2) IU/ kg/day. Nutrition was kept stable, After 7 days all subjects improved their respiratory condition but body weight remained the same and urin ary urea nitrogen and C-peptide were significantly higher (p < 0.001), rhGH intake strongly related to urinary excretion of urea nitrogen (r = 0.78) and C-peptide (r = 0.88). Dexamethasone improves the pulmonar y function of very preterm infants with bronchopulmonary dysplasia but induces growth arrest and catabolism which are not prevented, and may be worsened, by rhGH.