The effect of postnatal steroids on growth and development

Single courses of prenatal corticosteroids have many beneficial effects inc luding reduction in respiratory distress syndrome, intraventricular hemorrh age and neonatal mortality. Postnatal corticosteroids, however, have both b eneficial and harmful effects, The beneficial effects include shortened tim e on the ventilator and a reduction in chronic lung disease. Dexamethasone treatment started within the first 4 days of life is associated with an inc reased risk of abnormal neurodevelopment including cerebral palsy. Other ad verse effects include metabolic disturbances, cardiac hypertrophy, reduced growth and gastrointestinal perforation. The risks of early dexamethasone t reatment in currently used doses outweigh the benefits. Further research is needed to determine the optimal corticosteroid drug, its dose and timing o f administration to maximize benefit and reduce risk to a minimum. Other no n-drug interventions should be used to minimize the risk of chronic lung di sease in very preterm infants.