Neonatal dexamethasone therapy: short- and long-term consequences.

The discovery of the adrenal steroid hormones was one of the momentous events of science and medicine in the 20th century, highlighted by the awarding of the Nobel Prize in Physiology or Medicine to Kendall, Reichstein and Hench in 1950. Therapy using endogenous and synthetic corticosteroids was thought to be a miracle cure for several illnesses. We now recognize the many short- and long-term side effects of glucocorticoid therapy in neonates, children and adults, including growth retardation, insulin resistance, metabolic disturbances, cognitive and psychological problems, rapidly-progressing and profound osteoporosis, and iatrogenic Cushing's syndrome. Significant attention is now being paid to the long-term consequences of glucocorticoid therapy in premature and full-term neonates.