Association between total hydrocortisone dose and neurodevelopmental outcome at 3 years old in newborns under 28 weeks of gestation.

BACKGROUND

Ventilated very-low-birth-weight infants (VLBWIs) frequently receive hydrocortisone (HDC). The HDC dose increases in more serious cases, but the association between the actual HDC dose and neurodevelopmental outcomes is unclear.

METHOD: A total of 274 VLBWIs were divided into four groups according to the total HDC dose: zero (0 mg/kg), low (1-25 mg/kg), moderate (25-75 mg/kg), high (>75 mg/kg). The developmental quotient (DQ) in each group were compared. Using simple and multiple linear regression analyses, we evaluated the presence of a significant relationship between total DQ and total HDC dose in 274 and 153 VLBWIs receiving HDC therapy. In addition, the association between HDC therapy and the total DQ was investigated in 274 VLBWIs.

RESULTS

The total DQ in the zero group was significantly higher than that in the moderate and high groups but equivalent to that in the low group. Despite a significant association between total DQ and total HDC dose in the single linear regression analysis, no significant association was found between total DQ and total HDC dose in 274 VLBWIs (p = 0.07) and 153 VLBWIs receiving HDC (p = 0.18) using a multiple linear regression analysis, after adjusting for the days of artificial ventilation, gestational age, and the onset of late-stage circulatory collapse. No significant association was observed between total DQ and HDC therapy (p = 0.58).

CONCLUSION

HDC therapy during NICU admission may not have a significant effect on total DQ at three years old in VLBWIs.