Hydrocortisone for prevention or treatment of bronchopulmonary dysplasia: long-term neurodevelopmental safety and efficacy—a meta-analysis of randomized clinical trials - Report - MDSpire
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Hydrocortisone for prevention or treatment of bronchopulmonary dysplasia: long-term neurodevelopmental safety and efficacy—a meta-analysis of randomized clinical trials
Clinical Report: Efficacy and Long-Term Neurodevelopmental Safety of Hydrocortisone
Overview
This meta-analysis evaluates the efficacy of hydrocortisone in preventing bronchopulmonary dysplasia (BPD) in preterm infants.
Background
Bronchopulmonary dysplasia (BPD) is a major complication in extremely preterm infants, with systemic inflammation being a key risk factor. Previous use of dexamethasone raised concerns about long-term neurodevelopmental harm, prompting the investigation of hydrocortisone as a potentially safer alternative. Understanding the safety and efficacy of hydrocortisone is crucial for optimizing treatment strategies in this vulnerable population.
Data Highlights
Group
Death/NDI at 2 years
Death at 2 years
NDI at 2 years
Hydrocortisone
53.5% (531/993)
17.1%
42.5%
Placebo
56.8% (581/1,023)
20.8%
43.9%
Key Findings
Hydrocortisone did not significantly reduce the composite outcome of death or neurodevelopmental impairment (NDI) at 2 years.
At 2 years, 53.5% of infants receiving hydrocortisone experienced death/NDI compared to 56.8% in the placebo group.
No significant differences were observed in death rates (17.1% vs. 20.8%) or NDI rates (42.5% vs. 43.9%) between the two groups.
Hydrocortisone was not associated with significant differences in cerebral palsy, hearing impairment, or visual impairment.
Exploratory analyses showed no significant reduction in death or BPD at 36 weeks of postmenstrual age.
Available school-age outcomes did not demonstrate differences in neurocognitive measures.
Clinical Implications
The findings indicate that hydrocortisone does not increase the risk of major neurodevelopmental or sensory impairments when used in current regimens.
Conclusion
The meta-analysis indicates that hydrocortisone does not improve survival free of neurodevelopmental impairment at 2 years, nor does it increase the risk of significant neurodevelopmental issues.
by Kawthar Ahmed Shehab, Rahaf Muslih N. Almatrafi, Ethar Ali, Yara Albargi, Sama Saabi, Halah Alhassan Aljohani, Rayan Nabil Almuhanna, Raghad Alnaami, Khalid Abdulrahman Almehery, Reema Safar Alamri, Sarah Ahmed A. Baqer, Shouq Naif Aloufi, Ahmed Elaraby, Bedah Mohammed Alnawfal
