Growth and Neurodevelopment in Extremely Low-Birth-Weight Neonates Exposed to Postnatal Steroid Therapy

We compared postnatal growth and neurodevelopment in extremely low-birth-weight (<1000 g) neonates who did or did not receive postnatal steroid (PNS) therapy for bronchopulmonary dysplasia (BPD). One hundred seventy-three neonates with Bayley Scales of Infant Development II (BSID II) testing performed at 18- to 22-month adjusted age were studied. Growth parameters and BSID II scales were compared among three groups: group I, no BPD; group II, BPD, no PNS; group III, BPD and PNS exposure. A subset of 77 neonates' growth parameters were retrieved at 12-month adjusted age. Psychomotor Development Index (PDI) and Mental Development Index (MDI) scales were lower in group III versus groups I and II. Growth velocity (GV) was lower in group III versus group I and II during the initial hospital stay. In the subset, GV from birth to 1-year adjusted age and weight, length, and head circumference determined at 1-year adjusted age were similar among the groups. Multivariate analysis revealed a significant effect of group membership and cystic periventricular leukomalacia on PDI. These results suggest that a deleterious effect of PNS therapy on neurodevelopment can occur by a mechanism that does not impair overall growth or growth of head circumference.