J Korean Med Sci.  2004 Aug;19(4):514-518. 10.3346/jkms.2004.19.4.514.

Decreasing Incidence of Chronic Lung Disease Despite the Gradual Reduction of Postnatal Dexamethasone Use in Very Low Birth Weight Infants

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yschang@smc.samsung.co.kr
  • 2Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Pediatrics, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Bucheon Hospital., Soonchunhyang University College of Medicine, Bucheon, Korea.

Abstract

Dexamethasone has been widely used in very low birth weight infants (VLBWI) weighing less than 1,500 g at birth for the prevention or treatment of chronic lung disease (CLD). Recently, however the use of dexamethasone is being reduced, as its association with abnormal neurodevelopmental outcome is known. On the other hand, there have been persistent concerns about the increased risk of CLD according to the reduction of postnatal dexamethasone use. Hence, we did a retrospective cohort study to delineate the change in the incidence of CLD according to the reduction of dexamethasone use in VLBWI. The medical records of 559 VLBWI admitted to neonatal intensive care unit at Samsung Medical Center between November 1994 and December 2002 were reviewed with a focus on the use of postnatal dexamethasone and the incidence of CLD. The use of postnatal dexamethasone has significantly decreased over the study period. Especially, the use of high-dose regimen has markedly decreased. The day when postnatal dexamethasone therapy was begun has also been significantly delayed. The incidence of CLD has significantly decreased over the same period. In conclusion, the incidence of CLD has not increased despite the decreased use of postnatal dexamethasone.

Keyword

Dexamethasone; Bronchopulmonary Dysplasia; Infant; Premature

MeSH Terms

Chronic Disease
Cohort Studies
Dexamethasone/*therapeutic use
Gestational Age
Humans
Infant
Infant, Newborn
*Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Lung Diseases/*drug therapy/*epidemiology
Male
Retrospective Studies

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