Postnatal corticosteroid use for prevention or treatment of bronchopulmonary dysplasia in England and Wales 2012–2019: a retrospective population cohort study
Objective Describe the population of babies who do and do not receive postnatal corticosteroids for prevention or treatment of bronchopulmonary dysplasia (BPD).Design Retrospective cohort study using data held in the National Neonatal Research Database.Setting National Health Service neonatal units...
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Format: | Article |
Language: | English |
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BMJ Publishing Group
2022-11-01
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Series: | BMJ Open |
Online Access: | https://bmjopen.bmj.com/content/12/11/e063835.full |
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author | Neena Modi Chris Gale Iyad Al-Muzaffar Jonathan Cusack Victoria Nesbitt Sanjay Salgia Matthew Babirecki Aashish Gupta L M Wong Anita Mittal Ahmed Hassan Karin Schwarz Graham Whincup Abdul Hasib Mehdi Garbash David Gibson Pauline Adiotomre Abby Deketelaere Stanley Zengeya Cath Seagrave Hilary Dixon Narendra Aladangady Hassan Gaili Matthew James M Lal Lawrence Miall Venkatesh Kairamkonda J Kefas Jennifer Birch Gail Whitehead I Misra Subodh Gupta Steven Wardle Eleri Adams Minesh Khashu Charlotte Groves Christos Zipitis Peter De Halpert Joanne Fedee Stephen Jones Kirsten Mack Charlotte Huddy Salim Yasin Ngozi Edi-osagie Carrie Heal Jacqeline Birch Hari Kumar Chris Rawlingson Delyth Webb Sankara Narayanan Elizabeth Eyre Caroline Sullivan Wynne Leith Vimal Vasu Katia Vamvakiti Megan Eaton Ambalika Das Katharine Mcdevitt Anna Gregory Shu-Ling Chuang Sabita Uthaya Cheryl Battersby Imran Ahmed Chris Warren Tristan Bate Mark Johnson Sunil Reddy Rashmi Gandhi Nitin Goel Richard Hearn Cheentan Singh Faith Emery Vineet Gupta Yee Aung Vennila Ponnusamy Pinki Surana Anand Kamalanathan Kavi Aucharaz Lindsay Halpern Matt Nash Alex Allwood Nigel Brooke Jennifer Holman Geraint Lee Sobia Balal Poornima Pandey Ravindra Bhat Simon Rhodes Savi Sivashankar Michael Grosdenier Ajay Reddy Prakash Thiagarajan Chinnappa Reddy Lidia Tyszcuzk Glynis Rewitzky Bushra Abdul-Malik Dominic Muogbo Angela D'Amore John McIntyre Lucinda Winckworth Jim Baird Akinsola Ogundiya Pamela Cairns Porus Bastani Marice Theron Siba Paul Giles Kendall Puneet Nath Ros Garr Sundeep Sandhu Michael Cronin Alison Bedford Russell Ruchika Gupta Archana Mishra Oluseun Tayo Priya Muthukumar Brendan Harrington Victoria Sharp Nicola Johnson Sam Wallis Prashanth Bhat Lee Abbott Raju Narasimhan Kate Creese Divyen Shah Clare Cane Ghada Ramadan Sijia Yao Alistair Ewing Penelope Young Ramona Onita Joanne Dangerfield Jocelyn Morris Toria Klutse Sonia Spathis Sathish Krishnan Samar Sen Jez Jones Geedi Farah Prem Pitchaikani Jonathan Filkin Ashok Karupaiah Richard Heaver Mohammad Alam Tiziana Fragapane Jess Reynolds Khadija Ben-Sasi Patricia Cowley Shilpa Ramesh Julia Croft Soma Sengupta Nagendra Venkata Anitha Vayalakkad Ben Obi Anjali Petkar Arun Ramachandran Se-Yeon Park Sue Bird Jageer Mohammed Sanjay Jaisal |
author_facet | Neena Modi Chris Gale Iyad Al-Muzaffar Jonathan Cusack Victoria Nesbitt Sanjay Salgia Matthew Babirecki Aashish Gupta L M Wong Anita Mittal Ahmed Hassan Karin Schwarz Graham Whincup Abdul Hasib Mehdi Garbash David Gibson Pauline Adiotomre Abby Deketelaere Stanley Zengeya Cath Seagrave Hilary Dixon Narendra Aladangady Hassan Gaili Matthew James M Lal Lawrence Miall Venkatesh Kairamkonda J Kefas Jennifer Birch Gail Whitehead I Misra Subodh Gupta Steven Wardle Eleri Adams Minesh Khashu Charlotte Groves Christos Zipitis Peter De Halpert Joanne Fedee Stephen Jones Kirsten Mack Charlotte Huddy Salim Yasin Ngozi Edi-osagie Carrie Heal Jacqeline Birch Hari Kumar Chris Rawlingson Delyth Webb Sankara Narayanan Elizabeth Eyre Caroline Sullivan Wynne Leith Vimal Vasu Katia Vamvakiti Megan Eaton Ambalika Das Katharine Mcdevitt Anna Gregory Shu-Ling Chuang Sabita Uthaya Cheryl Battersby Imran Ahmed Chris Warren Tristan Bate Mark Johnson Sunil Reddy Rashmi Gandhi Nitin Goel Richard Hearn Cheentan Singh Faith Emery Vineet Gupta Yee Aung Vennila Ponnusamy Pinki Surana Anand Kamalanathan Kavi Aucharaz Lindsay Halpern Matt Nash Alex Allwood Nigel Brooke Jennifer Holman Geraint Lee Sobia Balal Poornima Pandey Ravindra Bhat Simon Rhodes Savi Sivashankar Michael Grosdenier Ajay Reddy Prakash Thiagarajan Chinnappa Reddy Lidia Tyszcuzk Glynis Rewitzky Bushra Abdul-Malik Dominic Muogbo Angela D'Amore John McIntyre Lucinda Winckworth Jim Baird Akinsola Ogundiya Pamela Cairns Porus Bastani Marice Theron Siba Paul Giles Kendall Puneet Nath Ros Garr Sundeep Sandhu Michael Cronin Alison Bedford Russell Ruchika Gupta Archana Mishra Oluseun Tayo Priya Muthukumar Brendan Harrington Victoria Sharp Nicola Johnson Sam Wallis Prashanth Bhat Lee Abbott Raju Narasimhan Kate Creese Divyen Shah Clare Cane Ghada Ramadan Sijia Yao Alistair Ewing Penelope Young Ramona Onita Joanne Dangerfield Jocelyn Morris Toria Klutse Sonia Spathis Sathish Krishnan Samar Sen Jez Jones Geedi Farah Prem Pitchaikani Jonathan Filkin Ashok Karupaiah Richard Heaver Mohammad Alam Tiziana Fragapane Jess Reynolds Khadija Ben-Sasi Patricia Cowley Shilpa Ramesh Julia Croft Soma Sengupta Nagendra Venkata Anitha Vayalakkad Ben Obi Anjali Petkar Arun Ramachandran Se-Yeon Park Sue Bird Jageer Mohammed Sanjay Jaisal |
author_sort | Neena Modi |
collection | DOAJ |
description | Objective Describe the population of babies who do and do not receive postnatal corticosteroids for prevention or treatment of bronchopulmonary dysplasia (BPD).Design Retrospective cohort study using data held in the National Neonatal Research Database.Setting National Health Service neonatal units in England and Wales.Patients Babies born less than 32 weeks gestation and admitted to neonatal units from 1 January 2012 to 31 December 2019.Main outcomes Proportion of babies given postnatal corticosteroid; type of corticosteroid; age at initiation and duration, trends over time.Secondary outcomes Survival to discharge, treatment for retinopathy of prematurity, BPD, brain injury, severe necrotising enterocolitis, gastrointestinal perforation.Results 8% (4713/62019) of babies born <32 weeks and 26% (3525/13527) born <27 weeks received postnatal corticosteroids for BPD. Dexamethasone was predominantly used 5.3% (3309/62019), followed by late hydrocortisone 1.5%, inhaled budesonide 1.5%. prednisolone 0.8%, early hydrocortisone 0.3% and methylprednisolone 0.05%. Dexamethasone use increased over time (2012: 4.5 vs 2019: 5.8%, p=0.04). Median postnatal age of initiation of corticosteroid course was around 3 weeks for late hydrocortisone, 4 weeks for dexamethasone, 6 weeks for inhaled budesonide, 12 weeks for prednisolone and 16 weeks for methylprednisolone. Babies who received postnatal corticosteroids were born more prematurely, had a higher incidence of comorbidities and a longer length of stay.Conclusions In England and Wales, around 1 in 12 babies born less than 32 weeks and 1 in 4 born less than 27 weeks receive postnatal corticosteroids to prevent or treat BPD. Given the lack of convincing evidence of efficacy, challenges of recruiting to and length of time taken to conduct randomised controlled trial, our data highlight the need to monitor long-term outcomes in children who received neonatal postnatal corticosteroids. |
first_indexed | 2024-04-11T14:36:26Z |
format | Article |
id | doaj.art-a1c9cf1736de4b08bb3863c44f9752bd |
institution | Directory Open Access Journal |
issn | 2044-6055 |
language | English |
last_indexed | 2024-04-11T14:36:26Z |
publishDate | 2022-11-01 |
publisher | BMJ Publishing Group |
record_format | Article |
series | BMJ Open |
spelling | doaj.art-a1c9cf1736de4b08bb3863c44f9752bd2022-12-22T04:18:19ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-063835Postnatal corticosteroid use for prevention or treatment of bronchopulmonary dysplasia in England and Wales 2012–2019: a retrospective population cohort studyNeena Modi0 1Chris Gale2Iyad Al-Muzaffar3Jonathan CusackVictoria Nesbitt4Sanjay SalgiaMatthew BabireckiAashish GuptaL M WongAnita MittalAhmed HassanKarin Schwarz5Graham WhincupAbdul HasibMehdi GarbashDavid GibsonPauline AdiotomreAbby DeketelaereStanley ZengeyaCath SeagraveHilary DixonNarendra AladangadyHassan GailiMatthew James6M Lal7Lawrence MiallVenkatesh KairamkondaJ KefasJennifer Birch8Gail WhiteheadI Misra9Subodh Gupta10Steven WardleEleri Adams11Minesh KhashuCharlotte Groves12Christos ZipitisPeter De HalpertJoanne FedeeStephen Jones13Kirsten MackCharlotte HuddySalim Yasin14Ngozi Edi-osagieCarrie HealJacqeline BirchHari Kumar15Chris RawlingsonDelyth WebbSankara Narayanan16Elizabeth EyreCaroline SullivanWynne LeithVimal VasuKatia VamvakitiMegan EatonAmbalika Das17Katharine McdevittAnna GregoryShu-Ling ChuangSabita Uthaya18Cheryl Battersby19Imran Ahmed20Chris Warren21Tristan Bate22Mark Johnson23Sunil Reddy24Rashmi Gandhi25Nitin Goel26Richard Hearn27Cheentan Singh28Faith Emery29Vineet Gupta30Yee Aung31Vennila Ponnusamy32Pinki Surana33Anand KamalanathanKavi AucharazLindsay HalpernMatt NashAlex AllwoodNigel BrookeJennifer Holman34Geraint LeeSobia BalalPoornima PandeyRavindra Bhat35Simon RhodesSavi SivashankarMichael GrosdenierAjay ReddyPrakash ThiagarajanChinnappa ReddyLidia TyszcuzkGlynis RewitzkyBushra Abdul-MalikDominic MuogboAngela D'AmoreJohn McIntyreLucinda Winckworth36Jim Baird37Akinsola OgundiyaPamela Cairns38Porus BastaniMarice TheronSiba Paul39Giles KendallPuneet Nath40Ros GarrSundeep Sandhu41Michael Cronin42Alison Bedford Russell43Ruchika Gupta44Archana Mishra45Oluseun Tayo46Priya Muthukumar47Brendan Harrington48Victoria SharpNicola JohnsonSam WallisPrashanth Bhat49Lee AbbottRaju Narasimhan50Kate Creese51Divyen Shah52Clare CaneGhada Ramadan53Sijia Yao54Alistair EwingPenelope YoungRamona OnitaJoanne DangerfieldJocelyn MorrisToria KlutseSonia SpathisSathish KrishnanSamar SenJez JonesGeedi FarahPrem PitchaikaniJonathan FilkinAshok KarupaiahRichard HeaverMohammad AlamTiziana FragapaneJess ReynoldsKhadija Ben-SasiPatricia CowleyShilpa RameshJulia CroftSoma SenguptaNagendra VenkataAnitha VayalakkadBen ObiAnjali PetkarArun RamachandranSe-Yeon ParkSue BirdJageer MohammedSanjay Jaisalprofessor of neonatal medicineUniversity of London, London, UKNeonatal Medicine, School of Public Health, Imperial College London, London, UK4 The Neonatal Unit, Royal Glamorgan Hospital, Llantrisant, Rhondda Cynon Taf, UKconsultant paediatrician3School of Paediatrics in Yorkshire and the Humber1 Community Health Sciences, University of Calgary, Calgary, Alberta, Canada5Neonatology, James Cook University Hospital, Middlesbrough, UK2Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, UKPaediatrics, Milton Keynes University Hospital, Milton Keynes, UKDepartment of Community Medicine, Dr. Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, IndiaNewborn Care Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK3 Women`s and Babies` Division, Women`s and Children`s Hospital, Adelaide, North Adelaide, South Australia, Australiamanaging director of Synapse Medical Resourcing Ltd and consultant to the pharmaceutical industrySt Helier8 Department of International Public Health and Disease Surveillance, Midwest, Australia1 Neonatology & Paediatrics, West Hertfordshire Hospitals NHS Trust, Watford, UK1Queens Hospital, Barking, Havering and Redbridge University Hospital NHS Trust, Romford, UKFaculty of Medicine, Imperial College London, London, UKNeonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UKDepartment of Paediatrics & Child Health, Aga Khan University, Karachi, Sindh, Pakistan3 Paediatrics, Royal Cornwall Hospitals NHS Trust, Truro, UKPaediatrics, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, Greater London, UKDepartment of Anaesthesia, Fiona Stanley Hospital and Freemantle Hospitals, Perth, Western Australia, AustraliaAff2 grid.168010.e0000000419368956Stanford University Medical Oncology Stanford CA USAKing’s College Hospital1 Department of Neonatal Medicine, University Hospital of Wales, Cardiff, UKRoyal Victoria Infirmary, Newcastle upon Tyne, Newcastle upon Tyne, UK1Department of Paediatric Nephrology, Evelina London Children`s Hospital, Guys & St Thomas NHS Foundation Trust, London, UKSouthmead Neonatal Unit, North Bristol NHS Trust, Westbury on Trym, UK4 Department of Internal Medicine, University of California San Diego, La Jolla, California, USADepartment of Children and Young People, North Cumbria University Hospitals National Health Service Trust, Whitehaven, UKNeonatal Intensive Care Unit, Ashford and St Peter’s Hospitals NHS Foundation Trust, Chertsey, Surrey, UKBirmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation TrustDepartment of Paediatrics and Neonatology, Gloucestershire Royal Hospital, Gloucester, UKNeonatal Intensive Care Unit, King`s College Hospital NHS Foundation Trust, London, UKPaediatrics Department, St Mary`s Hospital, Praed Street, London W2 1NY, UK; Lucinda_winckworth@hotmail.comThames Valley and Wessex Paediatric Critical Care Operational Delivery NetworkCentre for Ethics in Medicine, University of Bristol, Bristol, UK4Yeovil District HospitalNeonatal Intensive Care Unit, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UKEmbrace Yorkshire and Humber Infant and Children’s Transport Service, Sheffield, UKSaint James`s Hospital, Dublin, Ireland2 Birmingham Women`s NHS Foundation TrustDepartment of Pathology, Chacha Nehru Bal Chikitsalaya, New Delhi, IndiaDirectorate of Public Health & Family Welfare, National Health Mission, Madhya Pradesh, India1Department of Paediatrics, James Paget University Hospital, Gorleston, Great Yarmouth, UK5 Department of Paediatrics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UKconsultant paediatrician1Division of Asthma, Allergy and Lung Biology, MRC Centre for Allergic Mechanisms in Asthma, King`s College London, London, UK2Neonatal Unit, Royal Preston Hospital, Preston, Lancashire, UK4 Department of Paediatrics, Princess of Wales Hospital, Bridgend, UKspecialist registrar in neonatal paediatrics1 Oliver Fisher Neonatal Unit, Medway NHS Foundation Trust, Gillingham, UKNeonatal Medicine, Imperial College London, London, UKObjective Describe the population of babies who do and do not receive postnatal corticosteroids for prevention or treatment of bronchopulmonary dysplasia (BPD).Design Retrospective cohort study using data held in the National Neonatal Research Database.Setting National Health Service neonatal units in England and Wales.Patients Babies born less than 32 weeks gestation and admitted to neonatal units from 1 January 2012 to 31 December 2019.Main outcomes Proportion of babies given postnatal corticosteroid; type of corticosteroid; age at initiation and duration, trends over time.Secondary outcomes Survival to discharge, treatment for retinopathy of prematurity, BPD, brain injury, severe necrotising enterocolitis, gastrointestinal perforation.Results 8% (4713/62019) of babies born <32 weeks and 26% (3525/13527) born <27 weeks received postnatal corticosteroids for BPD. Dexamethasone was predominantly used 5.3% (3309/62019), followed by late hydrocortisone 1.5%, inhaled budesonide 1.5%. prednisolone 0.8%, early hydrocortisone 0.3% and methylprednisolone 0.05%. Dexamethasone use increased over time (2012: 4.5 vs 2019: 5.8%, p=0.04). Median postnatal age of initiation of corticosteroid course was around 3 weeks for late hydrocortisone, 4 weeks for dexamethasone, 6 weeks for inhaled budesonide, 12 weeks for prednisolone and 16 weeks for methylprednisolone. Babies who received postnatal corticosteroids were born more prematurely, had a higher incidence of comorbidities and a longer length of stay.Conclusions In England and Wales, around 1 in 12 babies born less than 32 weeks and 1 in 4 born less than 27 weeks receive postnatal corticosteroids to prevent or treat BPD. Given the lack of convincing evidence of efficacy, challenges of recruiting to and length of time taken to conduct randomised controlled trial, our data highlight the need to monitor long-term outcomes in children who received neonatal postnatal corticosteroids.https://bmjopen.bmj.com/content/12/11/e063835.full |
spellingShingle | Neena Modi Chris Gale Iyad Al-Muzaffar Jonathan Cusack Victoria Nesbitt Sanjay Salgia Matthew Babirecki Aashish Gupta L M Wong Anita Mittal Ahmed Hassan Karin Schwarz Graham Whincup Abdul Hasib Mehdi Garbash David Gibson Pauline Adiotomre Abby Deketelaere Stanley Zengeya Cath Seagrave Hilary Dixon Narendra Aladangady Hassan Gaili Matthew James M Lal Lawrence Miall Venkatesh Kairamkonda J Kefas Jennifer Birch Gail Whitehead I Misra Subodh Gupta Steven Wardle Eleri Adams Minesh Khashu Charlotte Groves Christos Zipitis Peter De Halpert Joanne Fedee Stephen Jones Kirsten Mack Charlotte Huddy Salim Yasin Ngozi Edi-osagie Carrie Heal Jacqeline Birch Hari Kumar Chris Rawlingson Delyth Webb Sankara Narayanan Elizabeth Eyre Caroline Sullivan Wynne Leith Vimal Vasu Katia Vamvakiti Megan Eaton Ambalika Das Katharine Mcdevitt Anna Gregory Shu-Ling Chuang Sabita Uthaya Cheryl Battersby Imran Ahmed Chris Warren Tristan Bate Mark Johnson Sunil Reddy Rashmi Gandhi Nitin Goel Richard Hearn Cheentan Singh Faith Emery Vineet Gupta Yee Aung Vennila Ponnusamy Pinki Surana Anand Kamalanathan Kavi Aucharaz Lindsay Halpern Matt Nash Alex Allwood Nigel Brooke Jennifer Holman Geraint Lee Sobia Balal Poornima Pandey Ravindra Bhat Simon Rhodes Savi Sivashankar Michael Grosdenier Ajay Reddy Prakash Thiagarajan Chinnappa Reddy Lidia Tyszcuzk Glynis Rewitzky Bushra Abdul-Malik Dominic Muogbo Angela D'Amore John McIntyre Lucinda Winckworth Jim Baird Akinsola Ogundiya Pamela Cairns Porus Bastani Marice Theron Siba Paul Giles Kendall Puneet Nath Ros Garr Sundeep Sandhu Michael Cronin Alison Bedford Russell Ruchika Gupta Archana Mishra Oluseun Tayo Priya Muthukumar Brendan Harrington Victoria Sharp Nicola Johnson Sam Wallis Prashanth Bhat Lee Abbott Raju Narasimhan Kate Creese Divyen Shah Clare Cane Ghada Ramadan Sijia Yao Alistair Ewing Penelope Young Ramona Onita Joanne Dangerfield Jocelyn Morris Toria Klutse Sonia Spathis Sathish Krishnan Samar Sen Jez Jones Geedi Farah Prem Pitchaikani Jonathan Filkin Ashok Karupaiah Richard Heaver Mohammad Alam Tiziana Fragapane Jess Reynolds Khadija Ben-Sasi Patricia Cowley Shilpa Ramesh Julia Croft Soma Sengupta Nagendra Venkata Anitha Vayalakkad Ben Obi Anjali Petkar Arun Ramachandran Se-Yeon Park Sue Bird Jageer Mohammed Sanjay Jaisal Postnatal corticosteroid use for prevention or treatment of bronchopulmonary dysplasia in England and Wales 2012–2019: a retrospective population cohort study BMJ Open |
title | Postnatal corticosteroid use for prevention or treatment of bronchopulmonary dysplasia in England and Wales 2012–2019: a retrospective population cohort study |
title_full | Postnatal corticosteroid use for prevention or treatment of bronchopulmonary dysplasia in England and Wales 2012–2019: a retrospective population cohort study |
title_fullStr | Postnatal corticosteroid use for prevention or treatment of bronchopulmonary dysplasia in England and Wales 2012–2019: a retrospective population cohort study |
title_full_unstemmed | Postnatal corticosteroid use for prevention or treatment of bronchopulmonary dysplasia in England and Wales 2012–2019: a retrospective population cohort study |
title_short | Postnatal corticosteroid use for prevention or treatment of bronchopulmonary dysplasia in England and Wales 2012–2019: a retrospective population cohort study |
title_sort | postnatal corticosteroid use for prevention or treatment of bronchopulmonary dysplasia in england and wales 2012 2019 a retrospective population cohort study |
url | https://bmjopen.bmj.com/content/12/11/e063835.full |
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