Evaluating the use of corticosteroids in preventing and treating bronchopulmonary dysplasia in preterm neonates

Oreoluwa Olaloko, Raihan Mohammed, Utkarsh Ojha, Oreoluwa Olaloko, Raihan Mohammed, Utkarsh Ojha

Abstract

Approximately 15 million babies worldwide are born premature, and complications of prematurity are one of the leading causes of death in neonates. Neonatal respiratory distress syndrome (NRDS) and bronchopulmonary dysplasia (BPD) are two of the most common and serious consequences of prematurity. Synthetic corticosteroids, including dexamethasone, have been central in efforts to treat and prevent BPD. There is strong evidence to show that prenatal corticosteroids reduce infant mortality and the incidence of NRDS, leading to their widespread use in obstetric units. However, data suggest that they are not as effective in reducing the incidence of BPD as NRDS, which may be due to the multifactorial pathogenesis of BPD. On the other hand, the use of postnatal corticosteroids in preterm infants is much more controversial. They have been shown to improve lung function and help in reducing the need for mechanical ventilation. These benefits, however, are associated with a range of adverse short- and long-term effects. This review will discuss the benefits and consequences of corticosteroids in treating BPD and will examine alternative treatments and future research that may improve the understanding of BPD and inform clinical practice.

Keywords: bronchopulmonary dysplasia; corticosteroids; postnatal; prenatal; preterm birth.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

References

    1. Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379(9832):2162–2172.
    1. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371(9606):75–84.
    1. Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2017;3:CD004454.
    1. Ramanathan R. Surfactant therapy in preterm infants with respiratory distress syndrome and in near-term or term newborns with acute RDS. J Perinatol. 2006;26(Suppl 1):S51–S56.
    1. Stevens TP, Harrington EW, Blennow M, Soll RF. Early surfactant administration with brief ventilation vs. selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome. Cochrane Database Syst Rev. 2007;4:CD003063.
    1. Northway WH, Jr, Rosan RC, Porter DY. Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med. 1967;276(7):357–368.
    1. Bancalari E, Abdenour G, Feller R, Gannon J. Bronchopulmonary dysplasia: clinical presentation. J Pediatr. 1979;95(5 Pt 2):819–823.
    1. Shennan AT, Dunn MS, Ohlsson A, Lennox K, Hoskins EM. Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period. Pediatrics. 1988;82(4):527–532.
    1. Davidson LM, Berkelhamer SK. Bronchopulmonary dysplasia: chronic lung disease of infancy and long-term pulmonary outcomes. J Clin Med. 2017;6(12):4.
    1. Ambalavanan N, Morty R. Searching for better animal models of BPD: a perspective. Am J Physiol Lung Cell Mol Physiol. 2016;311(5):L924–L927.
    1. Berkelhamer SK, Mestan KK, Steinhorn RH. Pulmonary hypertension in bronchopulmonary dysplasia. Semin Perinatol. 2013;37(2):124–131.
    1. Anderson PJ, Doyle LW. Neurodevelopmental outcome of bronchopulmonary dysplasia. Semin Perinatol. 2006;30(4):227–232.
    1. Chess PR, D’Angio CT, Pryhuber GS, Maniscalco WM. Pathogenesis of bronchopulmonary dysplasia. Semin Perinatol. 2006;30(4):171–178.
    1. Fowden AL, Li J, Forhead AJ. Glucocorticoids and the preparation for life after birth: are there long-term consequences of the life insurance? Proc Nutr Soc. 1998;57(1):113–122.
    1. Padbury JF, Ervin MG, Polk DH. Extrapulmonary effects of antenatally administered steroids. J Pediatr. 1996;128(2):167–172.
    1. Schellhase DE, Shannon JM. Effects of maternal dexamethasone on expression of SP-A, SP-B, and SP-C in the fetal rat lung. Am J Respir Cell Mol Biol. 1991;4(4):304–312.
    1. Bolt RJ, van Weissenbruch MM, Lafeber HN, Delemarrevan de Waal HA. Glucocorticoids and lung development in the fetus and preterm infant. Pediatr Pulmonol. 2001;32(1):76–91.
    1. Collins JJP, Tibboel D, de Kleer IM, Reiss IKM, Rottier RJ. The future of bronchopulmonary dysplasia: emerging pathophysiological concepts and potential new avenues of treatment. Front Med (Lausanne) 2017;4:61.
    1. Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics. 1972;50(4):515–525.
    1. Kinsella JP, Greenough A, Abman SH. Bronchopulmonary dysplasia. Lancet. 2006;367(9520):1421–1431.
    1. Tucker L, Hoff C, Peevy K, Brost B, Holland S, Calhoun B. The effects of antenatal steroid use in premature rupture of membranes. Aust N Z J Obstet Gynaecol. 1995;35(4):390–392.
    1. Mulder EJ, Derks JB, Zonneveld MF, Bruinse HW, Visser GH. Transient reduction in fetal activity and heart rate variation after maternal betamethasone administration. Early Hum Dev. 1994;36(1):49–60.
    1. Ehrenkranz RA. Single versus weekly courses of antenatal corticosteroids: evaluation of safety and efficacy. Yearbook Neonatal Perinatal Med. 2007;2007:25–26.
    1. Reynolds RM. Glucocorticoid excess and the developmental origins of disease: two decades of testing the hypothesis – 2012 Curt Richter Award Winner. Psychoneuroendocrinology. 2013;38(1):1–11.
    1. Kemp MW, Newnham JP, Challis JG, Jobe AH, Stock SJ. The clinical use of corticosteroids in pregnancy. Hum Reprod Update. 2016;22(2):240–259.
    1. Clyman R. The role of patent ductus arteriosus and its treatments in the development of bronchopulmonary dysplasia. Semin Perinatol. 2013;37(2):102–107.
    1. Chaudhary N, Filipov P, Bhutada A, Rastogi S. Controversies in the management of patent ductus arteriosus in preterm infants. J Neonatal Biol. 2016;5:238.
    1. Hong S, Levine L. Inhibition of arachidonic acid release from cells as the biochemical action of anti-inflammatory corticosteroids. Proc Natl Acad Sci U S A. 1976;73(5):1730–1734.
    1. Groneck P, Reuss D, Götze-Speer B, Speer CP. Effects of dexamethasone on chemotactic activity and inflammatory mediators in tracheobronchial aspirates of preterm infants at risk for chronic lung disease. J Pediatr. 1993;122(6):938–944.
    1. Mammel M, Johnson D, Green T, Thompson T. Controlled trial of dexamethasone therapy in infants with bronchopulmonary dysplasia. Lancet. 1983;321(8338):1356–1358.
    1. Jobe AH. Postnatal corticosteroids for bronchopulmonary dysplasia. Clin Perinatol. 2009;36(1):177–188.
    1. Baud O, Maury L, Lebail F, et al. Effect of early low-dose hydrocortisone on survival without bronchopulmonary dysplasia in extremely preterm infants (PREMILOC): a double-blind, placebo-controlled, multicentre, randomised trial. Lancet. 2016;387(10030):1827–1836.
    1. Walsh MC, Yao Q, Horbar JD, Carpenter JH, Lee SK, Ohlsson A. Changes in the use of postnatal steroids for bronchopulmonary dysplasia in 3 large neonatal networks. Pediatrics. 2006;118(5):e1328–e1335.
    1. Stoll BJ, Hansen NI, Bell EF, et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993 to 2012. Obstet Anesth Dig. 2016;36(2):76–77.
    1. Doyle LW, Cheong JL, Ehrenkranz RA, Halliday HL. Early (<8 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants. Cochrane Database Syst Rev. 2017;10:CD001146.
    1. Shinwell ES, Karplus M, Reich D, et al. Early postnatal dexamethasone treatment and increased incidence of cerebral palsy. Arch Dis Child Fetal Neonatal Ed. 2000;83(3):F177–F181.
    1. Yeh TF. Prevention of chronic lung disease (CLD) in premature infants with early dexamethasone therapy. Pediatr Pulmonol Suppl. 1997;23(S16):35–36.
    1. Zecca E, Papacci P, Maggio L, et al. Cardiac adverse effects of early dexamethasone treatment in preterm infants: a randomized clinical trial. J Clin Pharmacol. 2001;41(10):1075–1081.
    1. Shah SS, Ohlsson A, Halliday HL, Shah VS. Inhaled versus systemic corticosteroids for preventing bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates. Cochrane Database of Syst Rev. 2017;10:CD002058.
    1. Shinwell ES, Karplus M, Zmora E, et al. Failure of early postnatal dexamethasone to prevent chronic lung disease in infants with respiratory distress syndrome. Arch Dis Child Fetal Neonatal Ed. 1996;74(1):F33–F37.
    1. Durand M, Sardesai S, McEvoy C. Effects of early dexamethasone therapy on pulmonary mechanics and chronic lung disease in very low birth weight infants: a randomized, controlled trial. Pediatrics. 1995;95(6):584–590.
    1. Barrington KJ. The adverse neuro-developmental effects of postnatal steroids in the preterm infant: a systematic review of RCTs. BMC Pediatr. 2001;1:1.
    1. Howard E. Reductions in size and total DNA of cerebrum and cerebellum in adult mice after corticosterone treatment in infancy. Exp Neurol. 1968;22(2):191–208.
    1. Gramsbergen A, Mulder EJ. The influence of betamethasone and dexamethasone on motor development in young rats. Pediatr Res. 1998;44(1):105–110.
    1. Van Marter LJ, Kuban KC, Allred E, et al. ELGAN Study Investigators Does bronchopulmonary dysplasia contribute to the occurrence of cerebral palsy among infants born before 28 weeks of gestation? Arch Dis Child Fetal Neonatal Ed. 2011;96(1):F20–F29.
    1. Stavsky M, Mor O, Mastrolia SA, Greenbaum S, Than NG, Erez O. Cerebral palsy-trends in epidemiology and recent development in prenatal mechanisms of disease, treatment, and prevention. Front Pediatr. 2017;5:21.
    1. Hess GD, Joseph JA, Roth GS. Effect of age on sensitivity to pain and brain opiate receptors. Neurobiol Aging. 1981;2(1):49–55.
    1. Gupta S, Prasanth K, Chen CM, Yeh TF. Postnatal corticosteroids for prevention and treatment of chronic lung disease in the preterm newborn. Int J Pediatr. 2012;2012:315642.
    1. Doyle LW, Cheong JL, Ehrenkranz RA, Halliday HL. Late (> 7 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants. Cochrane Database Syst Rev. 2017;10:CD001145.
    1. Suchomski SJ, Cummings JJ. A randomized trial of inhaled versus intravenous steroids in ventilator-dependent preterm infants. J Perinatol. 2002;22(3):196–203.
    1. Huang CC, Lin HR, Liang YC, Hsu KS. Effects of neonatal corticosteroid treatment on hippocampal synaptic function. Pediatr Res. 2007;62(3):267–270.
    1. van der Heide-Jalving M, Kamphuis PJ, van der Laan MJ, et al. Short- and long-term effects of neonatal glucocorticoid therapy: is hydrocortisone an alternative to dexamethasone? Acta Paediatr. 2007;92(7):827–835.
    1. Mwansa-Kambafwile J, Cousens S, Hansen T, Lawn JE. Antenatal steroids in preterm labour for the prevention of neonatal deaths due to complications of preterm birth. Int J Epidemiol. 2010;39(Suppl 1):i122–i133.

Source: PubMed

3
S'abonner