Hydrocortisone for prevention or treatment of bronchopulmonary dysplasia: long-term neurodevelopmental safety and efficacy—a meta-analysis of randomized clinical trials - Summary - MDSpire

Hydrocortisone for prevention or treatment of bronchopulmonary dysplasia: long-term neurodevelopmental safety and efficacy—a meta-analysis of randomized clinical trials

  • 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

  • June 24, 2026

  • 0 min

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Objective:

To synthesize evidence on the use of hydrocortisone in preventing bronchopulmonary dysplasia (BPD) among infants born before 28 weeks of gestation and assess both benefits and adverse effects, particularly neurodevelopmental outcomes.

Approach:
  • Meta-Analysis: Conducted a meta-analysis of randomized controlled trials comparing hydrocortisone with placebo/routine care in preterm infants, stratified by early prophylaxis (<7 days) or late treatment (≥7 days).
Key Findings:
  • At 2 years, death/NDI occurred in 53.5% of infants in the hydrocortisone group (RR 0.89, 95% CI 0.70–1.13) and 56.8% in the placebo group (RR 0.97, 95% CI 0.80–1.17), with no significant effect from either early or late administration.
  • Hydrocortisone was not associated with significant differences in death (17.1% vs. 20.8%) or NDI (42.5% vs. 43.9%) at 2 years.
  • No significant reduction in death or BPD at 36 weeks of postmenstrual age was observed.
Interpretation:

Postnatal hydrocortisone was not associated with improved survival free of NDI at 2 years or with an increased risk of major neurodevelopmental or sensory impairments.

Limitations:
  • The analysis included studies with varying methodologies and follow-up durations.
  • Exploratory analyses may not have sufficient power to detect subtle differences.
Conclusion:

Hydrocortisone does not demonstrate increased neurodevelopmental risk as used in current regimens.

Sources:

Original Source(s)

Hydrocortisone for prevention or treatment of bronchopulmonary dysplasia: long-term neurodevelopmental safety and efficacy—a meta-analysis of randomized clinical trials

  • 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

  • June 24, 2026

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