Outcomes at school age after postnatal dexamethasone therapy for lung disease of prematurity

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 醫學院 > 醫學系 > 會議論文 > Item 310903500/27328

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题名:	Outcomes at school age after postnatal dexamethasone therapy for lung disease of prematurity
作者:	Yeh, TF;Lin, YJ;Lin, HC;Huang, CC;Hsieh, WS;Lin, CH;Tsai, CH
贡献者:	醫學院醫學系兒科部 China Med Univ, Coll Med, Dept Pediat, Taichung 40421, Taiwan;Natl Chung Kung Univ Hosp, Tainan, Taiwan;Natl Taiwan Univ, Taipei 10764, Taiwan
日期:	2004
上传时间:	2010-09-20 14:00:50 (UTC+8)
出版者:	MASSACHUSETTS MEDICAL SOC/NEJM
摘要:	BACKGROUND: We studied the outcomes at school age in children who had participated in a double-blind, placebo-controlled trial of early postnatal dexamethasone therapy (initiated within 12 hours after birth) for the prevention of chronic lung disease of prematurity. METHODS: Of the 262 children included in the initial study, 159 lived to school age. Of these children, 146 (72 in the dexamethasone group and 74 in the control group) were included in our study. All the infants had had severe respiratory distress syndrome requiring mechanical ventilation shortly after birth. In the dexamethasone group, 0.25 mg of dexamethasone per kilogram of body weight was given intravenously every 12 hours for one week, and then the dose was tapered. We evaluated the children's growth, neurologic and motor function, cognition, and school performance. RESULTS: Children in the dexamethasone group were significantly shorter than the controls (P=0.03 for boys, P=0.01 for girls, and P=0.03 for all children) and had a significantly smaller head circumference (P=0.04). Children in the dexamethasone group had significantly poorer motor skills (P<0.001), motor coordination (P<0.001), and visual-motor integration (P=0.02). As compared with the controls, children in the dexamethasone group also had significantly lower full IQ scores (mean [+/-SD], 78.2+/-15.0 vs. 84.4+/-12.6; P=0.008), verbal IQ scores (84.1+/-13.2 vs. 88.4+/-11.8, P=0.04), and performance IQ scores (76.5+/-14.6 vs. 84.5+/-12.7, P=0.001). The frequency of clinically significant disabilities was higher among children in the dexamethasone group than among controls (28 of 72 [39 percent] vs. 16 of 74 [22 percent], P=0.04). CONCLUSIONS: Early postnatal dexamethasone therapy should not be recommended for the routine prevention or treatment of chronic lung disease, because it leads to substantial adverse effects on neuromotor and cognitive function at school age.
關聯:	NEW ENGLAND JOURNAL OF MEDICINE 350(13):1304-1313
显示于类别:	[醫學系] 會議論文

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