Long-term sequelae of postnatal surfactant and corticosteroid therapies for BPD

Objective: This retrospective analysis assessed the relationship betweenmedical treatment (postnatal steroids, surfactant) received neonatally andoutcomes at 3 and 8 years using a longitudinal sample of children withbronchopulmonary dysplasia (BPD).Study Design: Four groups were formed retrospectively based on thetype of neonatal medical treatment received: no drug intervention(n ¼37), surfactant only (n ¼29), postnatal steroids only (n ¼13) andcombined surfactant and postnatal steroids (n ¼16). Groups werecompared on neurological and medical outcomes.Result: Combined postnatal steroids and surfactant treatment wasassociated with more days on supplemental oxygen than no interventionor surfactant only. Surfactant replacement therapy alone was notassociated with adverse consequences; however, postnatal steroid exposureappeared to be related.Conclusion: Although retrospective analyses make statements aboutcausation impossible, the differential relationships of therapies withcognitive outcomes argues for careful monitoring of therapeutic agentswith very low birth weight infants.Journal of Perinatology advance online publication, 27 March 2008;doi:10.1038/jp.2008.30Keywords: very low birth weight; medical management; intelligence;school performance