Non-neurological, steroid-related adverse events in very low birth weight infants: a prospective audit
BACKGROUND AND STUDY PURPOSE: To assess the incidence of cardiac and metabolic adverse events in very low birth weight (VLBW) infants receiving systematic steroids. PATIENTS AND METHODS: Prospective single centre audit in VLBW infants (<1,500 g) at the neonatal intensive care unit at...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2014-03-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1845 |
| _version_ | 1798003545507627008 |
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| author | Sebastian Benedikt Röhr Harald Sauer Sven Gottschling Hashim Abdul-Khaliq Ludwig Gortner Holger Nunold Stefan Gräber Sascha Meyer |
| author_facet | Sebastian Benedikt Röhr Harald Sauer Sven Gottschling Hashim Abdul-Khaliq Ludwig Gortner Holger Nunold Stefan Gräber Sascha Meyer |
| author_sort | Sebastian Benedikt Röhr |
| collection | DOAJ |
| description |
BACKGROUND AND STUDY PURPOSE: To assess the incidence of cardiac and metabolic adverse events in very low birth weight (VLBW) infants receiving systematic steroids.
PATIENTS AND METHODS: Prospective single centre audit in VLBW infants (<1,500 g) at the neonatal intensive care unit at the University Children’s Hospital of Saarland, Germany.
RESULTS: A total of 72 VLBW infants (38 female) were included in this report (mean birth weight: 967 ± 338 g; range: 320–1490 g). Birth weight, gestational age and Apgar scores were significantly lower in the steroid group (p <0.01). Mortality rate was 8/72 (7/34 in the steroid treated vs nontreated 1/38; odds ratio [OR]: 9.6; 95% confidence interval [CI]: 1.1–82.6 p = 0.02). In 34/72 infants, steroids were given (22 hydrocortisone alone; 12 combination of hydrocortisone and dexamethasone). The most common indication for use of steroids was respiratory distress syndrome (RDS) and respiratory insufficiency (30/34). Adverse events that occurred more often in the steroid group included hypertrophic cardiomyopathy (14/34 vs 0/38; p <0.001); thrombus formation (8/34 vs 1/38; OR: 11.4; 95% CI: 1.3-96.6; p <0.05), hyperglycaemia (27/34 vs 3/38; OR: 45.0; 95% CI: 10.6–190.4; p <0.01), hypernatraemia (15/34 vs 7/38; OR: 3.5; 95% CI: 1.2–10.1; p <0.05), and sepsis/infections (8/34 vs 1/38; OR: 11.4; 95% CI: 1.3–96.6; p <0.05). No significant differences were seen between hydrocortisone alone and the combination of hydrocortisone with dexamethasone. Birth weight and severity of RDS were predictors of steroid use (p <0.01).
CONCLUSIONS: The use of steroids was significantly associated with severe short-term adverse events – most importantly hypertrophic cardiomyopathy and thrombus formation. These complications must be taken into consideration when administering steroids to VLBW infants.
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| first_indexed | 2024-04-11T12:10:39Z |
| format | Article |
| id | doaj.art-39769e6c84764de29bc21fd186b8902b |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T12:10:39Z |
| publishDate | 2014-03-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-39769e6c84764de29bc21fd186b8902b2022-12-22T04:24:38ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972014-03-01144131410.4414/smw.2014.13954Non-neurological, steroid-related adverse events in very low birth weight infants: a prospective auditSebastian Benedikt RöhrHarald SauerSven GottschlingHashim Abdul-KhaliqLudwig GortnerHolger NunoldStefan GräberSascha Meyer BACKGROUND AND STUDY PURPOSE: To assess the incidence of cardiac and metabolic adverse events in very low birth weight (VLBW) infants receiving systematic steroids. PATIENTS AND METHODS: Prospective single centre audit in VLBW infants (<1,500 g) at the neonatal intensive care unit at the University Children’s Hospital of Saarland, Germany. RESULTS: A total of 72 VLBW infants (38 female) were included in this report (mean birth weight: 967 ± 338 g; range: 320–1490 g). Birth weight, gestational age and Apgar scores were significantly lower in the steroid group (p <0.01). Mortality rate was 8/72 (7/34 in the steroid treated vs nontreated 1/38; odds ratio [OR]: 9.6; 95% confidence interval [CI]: 1.1–82.6 p = 0.02). In 34/72 infants, steroids were given (22 hydrocortisone alone; 12 combination of hydrocortisone and dexamethasone). The most common indication for use of steroids was respiratory distress syndrome (RDS) and respiratory insufficiency (30/34). Adverse events that occurred more often in the steroid group included hypertrophic cardiomyopathy (14/34 vs 0/38; p <0.001); thrombus formation (8/34 vs 1/38; OR: 11.4; 95% CI: 1.3-96.6; p <0.05), hyperglycaemia (27/34 vs 3/38; OR: 45.0; 95% CI: 10.6–190.4; p <0.01), hypernatraemia (15/34 vs 7/38; OR: 3.5; 95% CI: 1.2–10.1; p <0.05), and sepsis/infections (8/34 vs 1/38; OR: 11.4; 95% CI: 1.3–96.6; p <0.05). No significant differences were seen between hydrocortisone alone and the combination of hydrocortisone with dexamethasone. Birth weight and severity of RDS were predictors of steroid use (p <0.01). CONCLUSIONS: The use of steroids was significantly associated with severe short-term adverse events – most importantly hypertrophic cardiomyopathy and thrombus formation. These complications must be taken into consideration when administering steroids to VLBW infants. https://www.smw.ch/index.php/smw/article/view/1845Postnatal steroids - Hydrocortisone - Dexamethasone - VLBW infant - Hypertrophic cardiomyopathy - Thrombus |
| spellingShingle | Sebastian Benedikt Röhr Harald Sauer Sven Gottschling Hashim Abdul-Khaliq Ludwig Gortner Holger Nunold Stefan Gräber Sascha Meyer Non-neurological, steroid-related adverse events in very low birth weight infants: a prospective audit Swiss Medical Weekly Postnatal steroids - Hydrocortisone - Dexamethasone - VLBW infant - Hypertrophic cardiomyopathy - Thrombus |
| title | Non-neurological, steroid-related adverse events in very low birth weight infants: a prospective audit |
| title_full | Non-neurological, steroid-related adverse events in very low birth weight infants: a prospective audit |
| title_fullStr | Non-neurological, steroid-related adverse events in very low birth weight infants: a prospective audit |
| title_full_unstemmed | Non-neurological, steroid-related adverse events in very low birth weight infants: a prospective audit |
| title_short | Non-neurological, steroid-related adverse events in very low birth weight infants: a prospective audit |
| title_sort | non neurological steroid related adverse events in very low birth weight infants a prospective audit |
| topic | Postnatal steroids - Hydrocortisone - Dexamethasone - VLBW infant - Hypertrophic cardiomyopathy - Thrombus |
| url | https://www.smw.ch/index.php/smw/article/view/1845 |
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