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Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort
Background: Postnatal steroids (PNS) have been used to prevent bronchopulmonary dysplasia (BPD) in preterm infants but have potential adverse effects on neurodevelopment. These effects might be modulated by their risk of BPD. We aimed to compare patients’ neurodevelopment with PNS treatment accordin...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106050/ https://www.ncbi.nlm.nih.gov/pubmed/35564997 http://dx.doi.org/10.3390/ijerph19095600 |
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author | Zayat, Noura Truffert, Patrick Drumez, Elodie Duhamel, Alain Labreuche, Julien Zemlin, Michael Milligan, David Maier, Rolf F. Jarreau, Pierre-Henri Torchin, Héloïse Zeitlin, Jennifer Nuytten, Alexandra , on behalf of the EPICE Research Group |
author_facet | Zayat, Noura Truffert, Patrick Drumez, Elodie Duhamel, Alain Labreuche, Julien Zemlin, Michael Milligan, David Maier, Rolf F. Jarreau, Pierre-Henri Torchin, Héloïse Zeitlin, Jennifer Nuytten, Alexandra , on behalf of the EPICE Research Group |
author_sort | Zayat, Noura |
collection | PubMed |
description | Background: Postnatal steroids (PNS) have been used to prevent bronchopulmonary dysplasia (BPD) in preterm infants but have potential adverse effects on neurodevelopment. These effects might be modulated by their risk of BPD. We aimed to compare patients’ neurodevelopment with PNS treatment according to their risk of BPD in a European cohort. Methods: We developed a prediction model for BPD to classify infants born between 24 + 0 and 29 + 6 weeks of gestation in three groups and compared patients’ neurological outcome at two years of corrected age using the propensity score (PS) method. Results: Of 3662 neonates included in the analysis, 901 (24.6%) were diagnosed with BPD. Our prediction model for BPD had an area under the ROC curve of 0.82. In the group with the highest risk of developing BPD, PNS were associated with an increased risk of gross motor impairment: OR of 1.95 after IPTW adjustment (95% CI 1.18 to 3.24, p = 0.010). This difference existed regardless of the type of steroid used. However, there was an increased risk of cognitive anomalies for patients treated with dexa/betamethasone that was no longer observed with hydrocortisone. Conclusions: This study suggests that PNS might be associated with an increased risk of gross motor impairment regardless of the group risk for BPD. Further randomised controlled trials exploring the use of PNS to prevent BPD should include a risk-based evaluation of neurodevelopmental outcomes. This observation still needs to be confirmed in a randomised controlled trial. |
format | Online Article Text |
id | pubmed-9106050 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91060502022-05-14 Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort Zayat, Noura Truffert, Patrick Drumez, Elodie Duhamel, Alain Labreuche, Julien Zemlin, Michael Milligan, David Maier, Rolf F. Jarreau, Pierre-Henri Torchin, Héloïse Zeitlin, Jennifer Nuytten, Alexandra , on behalf of the EPICE Research Group Int J Environ Res Public Health Article Background: Postnatal steroids (PNS) have been used to prevent bronchopulmonary dysplasia (BPD) in preterm infants but have potential adverse effects on neurodevelopment. These effects might be modulated by their risk of BPD. We aimed to compare patients’ neurodevelopment with PNS treatment according to their risk of BPD in a European cohort. Methods: We developed a prediction model for BPD to classify infants born between 24 + 0 and 29 + 6 weeks of gestation in three groups and compared patients’ neurological outcome at two years of corrected age using the propensity score (PS) method. Results: Of 3662 neonates included in the analysis, 901 (24.6%) were diagnosed with BPD. Our prediction model for BPD had an area under the ROC curve of 0.82. In the group with the highest risk of developing BPD, PNS were associated with an increased risk of gross motor impairment: OR of 1.95 after IPTW adjustment (95% CI 1.18 to 3.24, p = 0.010). This difference existed regardless of the type of steroid used. However, there was an increased risk of cognitive anomalies for patients treated with dexa/betamethasone that was no longer observed with hydrocortisone. Conclusions: This study suggests that PNS might be associated with an increased risk of gross motor impairment regardless of the group risk for BPD. Further randomised controlled trials exploring the use of PNS to prevent BPD should include a risk-based evaluation of neurodevelopmental outcomes. This observation still needs to be confirmed in a randomised controlled trial. MDPI 2022-05-05 /pmc/articles/PMC9106050/ /pubmed/35564997 http://dx.doi.org/10.3390/ijerph19095600 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Zayat, Noura Truffert, Patrick Drumez, Elodie Duhamel, Alain Labreuche, Julien Zemlin, Michael Milligan, David Maier, Rolf F. Jarreau, Pierre-Henri Torchin, Héloïse Zeitlin, Jennifer Nuytten, Alexandra , on behalf of the EPICE Research Group Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort |
title | Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort |
title_full | Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort |
title_fullStr | Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort |
title_full_unstemmed | Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort |
title_short | Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort |
title_sort | systemic steroids in preventing bronchopulmonary dysplasia (bpd): neurodevelopmental outcome according to the risk of bpd in the epice cohort |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106050/ https://www.ncbi.nlm.nih.gov/pubmed/35564997 http://dx.doi.org/10.3390/ijerph19095600 |
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