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Steroids hamper growth in newborns

Giving steroids to premature babies to treat breathing problems can substantially impair their growth, intelligence and development of motor abilities. Doctors have been using steroids, before as well as after delivery, in certain cases, since the 1970s, based on research that the drugs helped prevent breathing problems and increased survival. But in 2002, the American Academy of Pediatrics and the Canadian Pediatric Society recommended they no longer be used because of the potentially serious side effects of steroids.

Steroids hamper growth in newborns

Giving steroids to premature babies to treat breathing problems can substantially impair their growth, intelligence and development of motor abilities. Doctors have been using steroids, before as well as after delivery, in certain cases, since the 1970s, based on research that the drugs helped prevent breathing problems and increased survival. But in 2002, the American Academy of Pediatrics and the Canadian Pediatric Society recommended they no longer be used because of the potentially serious side effects of steroids. Researchers from the China Medical University in Taichung, studied the outcomes at school age in children who had participated in a placebo-controlled trial of early postnatal dexamethasone therapy (initiated within 12 hours after birth) for the prevention of chronic lung disease. Of the 262 children included in the initial study, 159 survived till school age. Of these children, 146 (72 in the dexamethasone group and 74 in the control group) were included in the study. It was found that children who had been given the steroid dexamethasone were easier to distract, performed mental tasks more slowly, and scored lower in tests of perception and grammar than children in the control group who received a saltwater placebo. In addition, 39 percent of the drug recipients had significant disabilities, compared with 22 percent who did not receive the steroid. Motor coordination was also impaired in more children who got dexamethasone for their severe respiratory distress syndrome. The researchers concluded that the drug stunted growth in children.
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Although the dexamethasone treatment did not seem to lower the death rate for the premature babies with breathing problems, it did reduce the risk of chronic lung disease 28 days after birth. Further research is still needed to define the role of steroids in children.

New England Journal of Medicine,
March 2004


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