Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort

Noura Zayat, Patrick Truffert, Elodie Drumez, Alain Duhamel, Julien Labreuche, Michael Zemlin, David Milligan, Rolf F. Maier, Pierre-Henri Jarreau, Héloïse Torchin, Jennifer Zeitlin, Alexandra Nuytten and On behalf of the EPICE Research Group
Additional contact information
Noura Zayat: Department of Neonatology, University Hospital of Nantes, F-44093 Nantes, France
Patrick Truffert: ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France
Elodie Drumez: ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France
Alain Duhamel: ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France
Julien Labreuche: ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France
Michael Zemlin: Department of General Paediatrics and Neonatology, Medical School, Saarland University, G-66421 Homburg, Germany
David Milligan: Faculty of Medical Science, Newcastle University, Newcastle upon Tyne UK-NE1 4LP, UK
Rolf F. Maier: Children’s Hospital, University Hospital, Philipps University Marburg, G-35043 Marburg, Germany
Pierre-Henri Jarreau: Neonatal Intensive Care Unit of Port-Royal, Cochin Hospital, APHP, F-75014 Paris, France
Héloïse Torchin: Neonatal Intensive Care Unit of Port-Royal, Cochin Hospital, APHP, F-75014 Paris, France
Jennifer Zeitlin: CRESS, Obstetrical Perinatal and Paediatric Epidemiology Research Team, EPOPé, INSERM, INRA, University of Paris, F-75004 Paris, France
Alexandra Nuytten: ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France
On behalf of the EPICE Research Group: A complete list of the group members appears in the Acknowledgements.

IJERPH, 2022, vol. 19, issue 9, 1-11

Abstract: 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.

Keywords: neurodevelopmental outcome; bronchopulmonary dysplasia; preterm birth; post natal steroid therapy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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