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Adverse effects of early dexamethasone in extremely-low-birth-weight infants. National Institute of Child Health and Human Development Neonatal Research Network

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Please use this identifier to cite or link to this item: http://hdl.handle.net/1928/1926

Adverse effects of early dexamethasone in extremely-low-birth-weight infants. National Institute of Child Health and Human Development Neonatal Research Network

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dc.contributor.author Stark, AR en_US
dc.contributor.author Carlo, WA en_US
dc.contributor.author Tyson, JE en_US
dc.contributor.author Papile, LA en_US
dc.contributor.author Wright, LL en_US
dc.contributor.author Shankaran, S en_US
dc.contributor.author Donovan, EF en_US
dc.contributor.author Oh, W en_US
dc.contributor.author Bauer, CR en_US
dc.contributor.author Saha, S en_US
dc.contributor.author Poole, WK en_US
dc.contributor.author Stoll, BJ en_US
dc.contributor.author National Institute of Child Health and Human Development Neonatal Research Network en_US
dc.date.accessioned 2006-09-20T15:10:06Z
dc.date.available 2006-09-20T15:10:06Z
dc.date.issued 2006-09-20T15:10:06Z
dc.identifier.citation 2001 Jan 11;344(2):95-101 en_US
dc.identifier.uri http://hdl.handle.net/1928/1926
dc.description PubMed ID: 11150359 en_US
dc.description.abstract BACKGROUND: Early administration of high doses of dexamethasone may reduce the risk of chronic lung disease in premature infants but can cause complications. Whether moderate doses would be as effective but safer is not known. METHODS: We randomly assigned 220 infants with a birth weight of 501 to 1000 g who were treated with mechanical ventilation within 12 hours after birth to receive dexamethasone or placebo with either routine ventilatory support or permissive hypercapnia. The dexamethasone was administered within 24 hours after birth at a dose of 0.15 mg per kilogram of body weight per day for three days, followed by a tapering of the dose over a period of seven days. The primary outcome was death or chronic lung disease at 36 weeks' postmenstrual age. RESULTS: The relative risk of death or chronic lung disease in the dexamethasone-treated infants, as compared with those who received placebo, was 0.9 (95 percent confidence interval, 0.8 to 1.1). Since the effect of dexamethasone treatment did not vary according to the ventilatory approach, the two dexamethasone groups and the two placebo groups were combined. The infants in the dexamethasone group were less likely than those in the placebo group to be receiving oxygen supplementation 28 days after birth (P=0.004) or open-label dexamethasone (P=0.01), were more likely to have hypertension (P<0.001), and were more likely to be receiving insulin treatment for hyperglycemia (P=0.02). During the first 14 days, spontaneous gastrointestinal perforation occurred in a larger proportion of infants in the dexamethasone group (13 percent, vs. 4 percent in the placebo group; P=0.02). The dexamethasone-treated infants had a lower weight (P=0.02) and a smaller head circumference (P=0.04) at 36 weeks' postmenstrual age. CONCLUSIONS: In preterm infants, early administration of dexamethasone at a moderate dose has no effect on death or chronic lung disease and is associated with gastrointestinal perforation and decreased growth. en_US
dc.format.extent 1767 bytes
dc.format.extent 30720 bytes
dc.format.mimetype text/plain
dc.format.mimetype application/msword
dc.language.iso en_US en_US
dc.publisher Stark, AR - The New England journal of medicine en_US
dc.subject early dexamethasone en_US
dc.subject extremely-low-birth-weight infants en_US
dc.subject National Institute of Child Health and Human Development Neonatal Research Network en_US
dc.title Adverse effects of early dexamethasone in extremely-low-birth-weight infants. National Institute of Child Health and Human Development Neonatal Research Network en_US


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