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Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort

Author

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  • Noura Zayat

    (Department of Neonatology, University Hospital of Nantes, F-44093 Nantes, France
    ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France)

  • Patrick Truffert

    (ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France
    Department of Neonatology, Jeanne de Flandre University Hospital, F-59000 Lille, France)

  • Elodie Drumez

    (ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France
    Department of Biostatistics, CHU Lille, F-59000 Lille, France)

  • Alain Duhamel

    (ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France
    Department of Biostatistics, CHU Lille, F-59000 Lille, France)

  • Julien Labreuche

    (ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France
    Department of Biostatistics, CHU Lille, F-59000 Lille, France)

  • Michael Zemlin

    (Department of General Paediatrics and Neonatology, Medical School, Saarland University, G-66421 Homburg, Germany)

  • David Milligan

    (Faculty of Medical Science, Newcastle University, Newcastle upon Tyne UK-NE1 4LP, UK)

  • Rolf F. Maier

    (Children’s Hospital, University Hospital, Philipps University Marburg, G-35043 Marburg, Germany)

  • Pierre-Henri Jarreau

    (Neonatal Intensive Care Unit of Port-Royal, Cochin Hospital, APHP, F-75014 Paris, France
    CRESS, Obstetrical Perinatal and Paediatric Epidemiology Research Team, EPOPé, INSERM, INRA, University of Paris, F-75004 Paris, France)

  • Héloïse Torchin

    (Neonatal Intensive Care Unit of Port-Royal, Cochin Hospital, APHP, F-75014 Paris, France
    CRESS, Obstetrical Perinatal and Paediatric Epidemiology Research Team, EPOPé, INSERM, INRA, University of Paris, F-75004 Paris, France)

  • Jennifer Zeitlin

    (CRESS, Obstetrical Perinatal and Paediatric Epidemiology Research Team, EPOPé, INSERM, INRA, University of Paris, F-75004 Paris, France)

  • Alexandra Nuytten

    (ULR 2694—METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, F-59000 Lille, France
    Department of Neonatology, Jeanne de Flandre University Hospital, F-59000 Lille, France)

  • On behalf of the EPICE Research Group

    (A complete list of the group members appears in the Acknowledgements.)

Abstract

Background: Postnatal steroids (PNS) have been used to prevent bronchopulmonary dysplasia (BPD) in preterm infants but have potential adverse effects on neurodevelopment. These effects might be modulated by their risk of BPD. We aimed to compare patients’ neurodevelopment with PNS treatment according to their risk of BPD in a European cohort. Methods: We developed a prediction model for BPD to classify infants born between 24 + 0 and 29 + 6 weeks of gestation in three groups and compared patients’ neurological outcome at two years of corrected age using the propensity score (PS) method. Results: Of 3662 neonates included in the analysis, 901 (24.6%) were diagnosed with BPD. Our prediction model for BPD had an area under the ROC curve of 0.82. In the group with the highest risk of developing BPD, PNS were associated with an increased risk of gross motor impairment: OR of 1.95 after IPTW adjustment (95% CI 1.18 to 3.24, p = 0.010). This difference existed regardless of the type of steroid used. However, there was an increased risk of cognitive anomalies for patients treated with dexa/betamethasone that was no longer observed with hydrocortisone. Conclusions: This study suggests that PNS might be associated with an increased risk of gross motor impairment regardless of the group risk for BPD. Further randomised controlled trials exploring the use of PNS to prevent BPD should include a risk-based evaluation of neurodevelopmental outcomes. This observation still needs to be confirmed in a randomised controlled trial.

Suggested Citation

  • Noura Zayat & Patrick Truffert & Elodie Drumez & Alain Duhamel & Julien Labreuche & Michael Zemlin & David Milligan & Rolf F. Maier & Pierre-Henri Jarreau & Héloïse Torchin & Jennifer Zeitlin & Alexan, 2022. "Systemic Steroids in Preventing Bronchopulmonary Dysplasia (BPD): Neurodevelopmental Outcome According to the Risk of BPD in the EPICE Cohort," IJERPH, MDPI, vol. 19(9), pages 1-11, May.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:9:p:5600-:d:808721
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    References listed on IDEAS

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    1. van Buuren, Stef & Groothuis-Oudshoorn, Karin, 2011. "mice: Multivariate Imputation by Chained Equations in R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 45(i03).
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