Abstract :
Keywords Bronchopulmonary dysplasia; BPD; Chronic lung disease; CLD; Hydrocortisone Highlights * Bronchopulmonary dysplasia (BPD) contributes to significant morbidity in ex-preterm infants. * Hydrocortisone as a prophylactic in extreme prematurity has been associated with an increase in BPD free survival. * Hydrocortisone has been associated with an increase in late onset sepsis and spontaneous gastro-intestinal perforation. * This study of * Adverse incidents were not increased in the hydrocortisone cohort. Abstract Objective To assess the safety of the routine use of low-dose prophylactic hydrocortisone to improve survival without bronchopulmonary dysplasia (BPD) in infants born Design A single-centre retrospective cohort study of infants born Main outcome measures The incidence of serious adverse events associated with hydrocortisone use was measured in each group. The rates of spontaneous intestinal perforation (SIP), late onset sepsis (LOS). Necrotising enterocolitis (NEC) and BPD were compared. Results There were 88 infants in the pre-hydrocortisone group and 103 infants in the hydrocortisone group. In comparison to the pre-hydrocortisone group, the incidence of SIP in the hydrocortisone group was 7.7 % (vs 3.4 % p = 0.2), NEC 30 % (vs 25 % p = 0.43) and LOS 34 % (vs 30.6 % p = 0.63) Rates of BPD in the hydrocortisone group were 59 % (vs 52.2 % p = 0.33) mortality 18.4 % (vs 20.4 % p = 0.73) and BPD free survival 26.2 % (vs 27.2 % p = 0.87). Infants who received hydrocortisone had a significantly lower requirement of inotropic support of 32 % vs 48.3 % (p = 0.02). Results remained unchanged after logistic regression analyses for potential confounding factors (ethnicity, chorioamnionitis, multiple pregnancy and antenatal steroids). Conclusion Prophylactic administration of low-dose hydrocortisone for BPD to infants born below 28 weeks' gestation was not associated with an increase in serious adverse outcomes in our population. Author Affiliation: St Thomas Hospital, Neonatal Intensive Care Unit, Westminster Bridge Road, London SE1 7EH, United Kingdom of Great Britain and Northern Ireland * Corresponding author at: St Peter's Hospital, Neonatal Intensive Care unit, Guildford Street, Lyne, Chertsey, Surrey KT16 0PZ, United Kingdom of Great Britain and Northern Ireland. Article History: Received 22 May 2022; Revised 5 July 2022; Accepted 5 July 2022 Byline: Alexandra Briscoe [Alexandra.briscoe2@nhs.net] (*), Chinthika Piyasena, Virginie Meau-Petit