Cognitive outcomes of extremely preterm infants at 6.5 years after postnatal corticosteroid treatment, a pilot study

Extremely preterm born infants are at risk for neurodevelopmental impairments. Corticosteroids are used to reduce systemic inflammation. Early dexamethasone therapy is associated with poorer neurodevelopmental outcomes; thus, hydrocortisone is currently widely used. However, the long-term effects of hydrocortisone treatment on neurodevelopmental outcomes remain unclear, and thus, we conducted a pilot study of extremely preterm infants. The study cohort included 66 extremely preterm born infants, who were followed up for 6.5 years. Data on corticosteroid treatment were collected from medical records, and the cumulative doses of hydrocortisone and dexamethasone were calculated. Cognitive outcomes at 6.5 years were assessed using a standardized test of intelligence, and the associations with corticosteroid therapy were evaluated. Twentynine (44 %) children were treated with corticosteroids, 18 with hydrocortisone, 3 with dexamethasone, and 8 with hydrocortisone and dexamethasone. The mean Full-scale (FSIQ), Performance (PIQ) and Verbal (VIQ) Intelligence Quotients did not differ significantly between children treated with corticosteroids and those not treated at 6.5 years. The incidence of cognitive impairment (FSIQ, PIQ and VIQ < 85) was higher in children treated with corticosteroids than in those not treated. However, the difference was not statistically significant. This pilot study indicates that high-dose postnatal corticosteroid treatment may have long-term adverse effects on cognitive development. Longitudinal studies of the long-term effects of corticosteroid treatment are required to clarify their safety. .