Hydrocortisone does not improve risk of death or bronchopulmonary dysplasia in preterm babies: JAMA

The key outcome at 2 years corrected age was a composite of death or Neurodevelopmental impairment (NDI). At 2 years' corrected age, 356 of 371 infants (96%) were evaluated for the outcome of death or NDI.

The results of the study are as follows:

· Out of the total 95 infants died, and neurodevelopment assessment was performed in 95% (262/276) of survivors.

· Baseline characteristics showed a higher parental education level and more multiple births in the hydrocortisone group.

· Occurrence of death or NDI was 56.7% (97/171) in the hydrocortisone group and 62.7% (116/185) in the placebo group.

· The rate of death was 21.5% (39/181) in the hydrocortisone group and 29.5% (56/190) in the placebo group.

· NDI occurred in 43.9% (58/132) of the hydrocortisone group and 46.5% (60/129) of the placebo group.

· The individual NDI domains were not significantly different between the groups.

· Adjustment for preselected risk factors did not change these findings.

The researchers concluded that there was no significant difference in the composite outcome death or NDI at 2 years' corrected age in ventilated very preterm infants treated with systemic hydrocortisone initiated in the second week of life to reduce the risk of death or bronchopulmonary dysplasia. Still, the possible beneficial hydrocortisone effect on survival needs further investigation.

Reference:

Effect of Systemic Hydrocortisone Initiated 7 to 14 Days After Birth in Ventilated Preterm Infants on Mortality and Neurodevelopment at 2 Years' Corrected Age: Follow-up of a Randomized Clinical Trial by Halbmeijer N et. al published in the JAMA.

doi:10.1001/jama.2021.9380