The effects of early postnatal dexamethasone therapy on pulmonary outcome in premature infants with respiratory distress syndrome: A two-year follow-up study

Aim: To evaluate the pulmonary outcome at corrected age of 2 y on preterm infants who participated in a double-blind trial of early postnatal dexamethasone therapy (< 12 h after birth) for the prevention of chronic lung disease. Methods: Clinical respiratory status, blood gases, acid-base balance and pulmonary function were evaluated at corrected age of 2 y in 116 preterm infants (59 infants in the control group; 57 in the dexamethasone-treated group). In the dexamethasone-treated group, dexamethasone was administered intravenously every 12 h in tapering doses: 0.25 mg/kg on days 1 through 7, 0.12 mg/kg on days 8 through 14, 0.05 mg/kg on days 15 through 21, and 0.02 mg/kg on days 21 through 28. Results: The clinical and laboratory characteristics in the perinatal period were comparable between the groups. At the time of follow-up (mean±SD corrected age was 25.1 ± 4.8 mo for the control group and 24.6 ± 5.1 mo for the dexamethasone-treated group), there was a slightly lower mean body weight and body length, and a lower psychomotor developmental index in the dexamethasone-treated group than in the control group (10.9 ± 2.1 vs 11.5 ± 1.9 kg, 84.4 ± 6.1 vs 85.9 ± 5.8 cm, and 82 ± 24 vs 89 ± 26, respectively); however, these differences were not statistically significant. There were no significant differences between the control and dexamethasone-treated groups in clinical respiratory status, blood gases, acid-base balance or in lung mechanics (V_T: 9.5 ± 2.0 vs 9.4 ± 1.9 ml/kg; V_min: 0.23 ± 0.04 vs 0.23 ± 0.03 l/min/kg; C_RS: 13.1 ± 3.9 vs 12.6 ± 3.6 ml/kPa/kg; R_RS: 1.56 ± 0.64 vs 1.62 ± 0.58 kPa/l/s, respectively). Conclusion: There was no apparent adverse respiratory outcome associated with early postnatal dexamethasone therapy.