Assessment of Corticosteroid Therapy and Death or Disability According to Pretreatment Risk of Death or Bronchopulmonary Dysplasia in Extremely Preterm Infants-Reference-Cited by-同舟云学术

Assessment of Corticosteroid Therapy and Death or Disability According to Pretreatment Risk of Death or Bronchopulmonary Dysplasia in Extremely Preterm Infants

Published:2023-05-08 Issue:5 Volume:6 Page:e2312277
ISSN:2574-3805
Container-title:JAMA Network Open
language:en
Short-container-title:JAMA Netw Open

Author:

Jensen Erik A.¹,Wiener Laura Elizabeth²,Rysavy Matthew A.³,Dysart Kevin C.⁴,Gantz Marie G.²,Eichenwald Eric C.¹,Greenberg Rachel G.⁵,Harmon Heidi M.⁶,Laughon Matthew M.⁷,Watterberg Kristi L.⁸,Walsh Michele C.⁹,Yoder Bradley A.¹⁰,Lorch Scott A.¹,DeMauro Sara B.¹,Polin Richard A.¹¹,Laptook Abbot R.¹¹,Keszler Martin¹¹,Vohr Betty R.¹¹,Hensman Angelita M.¹¹,Vieira Elisa¹¹,Pierre Lucille St.¹¹,Burke Robert T.¹¹,Alksninis Barbara¹¹,Knoll Andrea¹¹,Keszler Mary L.¹¹,Leach Teresa M.¹¹,McGowan Elisabeth C.¹¹,Watson Victoria E.¹¹,Hibbs Anna Maria¹¹,Newman Nancy S.¹¹,Wilson-Costello Deanne E.¹¹,Siner Bonnie S.¹¹,Friedman Harriet G.¹¹,Truog William E.¹¹,Pallotto Eugenia K.¹¹,Kilbride Howard W.¹¹,Gauldin Cheri¹¹,Holmes Anne¹¹,Johnson Kathy¹¹,Scott Allison¹¹,Parimi Prabhu S.¹¹,Gaetano Lisa¹¹,Merhar Stephani L.¹¹,Schibler Kurt¹¹,Poindexter Brenda B.¹¹,Yolton Kimberly¹¹,Cahill Tanya E.¹¹,Gratton Teresa L.¹¹,Grisby Cathy¹¹,Kirker Kristin¹¹,Wuertz Sandra¹¹,Cotten Michael C.¹¹,Goldberg Ronald N.¹¹,Goldstein Ricki F.¹¹,Malcolm William F.¹¹,Ashley Patricia L.¹¹,Mago-Shah Deesha¹¹,Finkle Joanne¹¹,Fisher Kimberley A.¹¹,Gustafson Kathryn E.¹¹,Bose Carl L.¹¹,Bernhardt Janice¹¹,Bose Gennie¹¹,Wereszczak Janice¹¹,Warner Diane¹¹,Talbert Jennifer¹¹,Kicklighter Stephen D.¹¹,Bentley Alexandra¹¹,Edwards Laura¹¹,Rhodes-Ryan Ginger¹¹,White Donna¹¹,Patel Ravi M.¹¹,Carlton David P.¹¹,Loggins Yvonne¹¹,Adams-Chapman (deceased) Ira¹¹,Bottcher Diane¹¹,Carter Sheena L.¹¹,Hale Ellen C.¹¹,Kendrick-Allwood Salathiel¹¹,Mulligan LaRossa Maureen¹¹,Mackie Colleen¹¹,Sanders Amy¹¹,Smikle Gloria¹¹,Wineski Lynn¹¹,Bremer Andrew A.¹¹,Higgins Rosemary D.¹¹,Wilson Archer Stephanie¹¹,Sokol Gregory M.¹¹,Harmon Heidi¹¹,Papile Lu Ann¹¹,Herron Dianne E.¹¹,Hines Abbey C.¹¹,Lytle Carolyn¹¹,Smiley Lucy¹¹,Wilson Leslie Dawn¹¹,Tyson Jon E.¹¹,Khan Amir M.¹¹,Kennedy Kathleen A.¹¹,Stoll Barbara J.¹¹,Mosquera Riciardo A.¹¹,Duncan Andrea F.¹¹,Stephens Emily¹¹,Allain Elizabeth¹¹,Arldt-McAlister Julie¹¹,Boricha Fatima¹¹,Burson Katrina¹¹,Dempsey Allison G.¹¹,Evans Patricia W.¹¹,Garcia Carmen¹¹,Hall Donna J.¹¹,Jiminez Margarita¹¹,John Janice¹¹,Jones Patrick M.¹¹,Lillie M. Layne¹¹,Martin Karen¹¹,Martin Sara C.¹¹,McDavid Georgia E.¹¹,McKee Shannon L.¹¹,Poe Michelle¹¹,Rennie Kimberly¹¹,Reddy Tina¹¹,Rodgers Shawna¹¹,Khan Siddiki Saba¹¹,Sperry Daniel¹¹,Pierce Tate Patti L.¹¹,Wright Sharon L.¹¹,Sánchez Pablo J.¹¹,Slaughter Jonathan L.¹¹,Nelin Leif D.¹¹,Jadcherla Sudarshan R.¹¹,Maitre Nathalie L.¹¹,Timan Christopher¹¹,Yeates Keith O.¹¹,Luzader Patricia¹¹,Batterson Nancy¹¹,Baugher Hallie¹¹,Beckford Demi R.¹¹,Burkhardt Stephanie¹¹,Carey Helen¹¹,Chao Michelle¹¹,Cira Courtney¹¹,Clark Erna¹¹,DeSantis Brittany¹¹,Fortney Christine A.¹¹,Fowler Aubrey¹¹,Gutentag Julie¹¹,Grothause Jennifer L.¹¹,Hague Cole D.¹¹,Keim Sarah A.¹¹,Levengood Katelyn¹¹,Marzec Laura¹¹,McCool Jacqueline¹¹,Miller Bethany¹¹,Nelin Mary Ann¹¹,Newton Julia¹¹,Park Courtney¹¹,Pietruszewski Lindsay¹¹,Purnell Jessica¹¹,Seabrook Ruth¹¹,Shadd Julie C.¹¹,Small Kristi¹¹,Stein Melanie¹¹,Sullivan Margaret¹¹,Sullivan Rox Ann¹¹,Warnimont Krystin¹¹,Yossef-Salameh Lina¹¹,Fearns Erin¹¹,Das Abhik¹¹,Gantz Marie G.¹¹,Bann Carla M.¹¹,Wallace Dennis¹¹,O'Donnell Auman Jeanette¹¹,Crawford Margaret¹¹,Gabrio Jenna¹¹,Newman Jamie E.¹¹,Parlberg Lindsay¹¹,Petrie Huitema Carolyn M.¹¹,Zaterka-Baxter Kristin M.¹¹,Van Meurs Krisa P.¹¹,Chock Valerie Y.¹¹,Stevenson David K.¹¹,Hintz Susan R.¹¹,Ball Bethany M.¹¹,Adams Marian M.¹¹,Bahmani Dona¹¹,Bentley Barbara¹¹,DeAnda Maria Elena¹¹,DeBattista Anne M.¹¹,Earhart Beth¹¹,Huffman Lynne C.¹¹,Krueger Casey E.¹¹,Lucash Ryan E.¹¹,Proud Melinda S.¹¹,Reichert Elizabeth N.¹¹,Taylor Heather¹¹,Weiss Hali E.¹¹,Williams Jordan R.¹¹,Carlo Waldemar A.¹¹,Ambalavanan Namasivayam¹¹,Peralta-Carcelen Myriam¹¹,Collins Monica V.¹¹,Cosby Shirley S.¹¹,Bailey Kirstin J.¹¹,Biasini Fred J.¹¹,Chopko Stephanie A.¹¹,Domnanovich Kristy A.¹¹,Jno-Finn Chantel J.¹¹,Ladinsky Morissa¹¹,Moses Mary Beth¹¹,McNair Tara E.¹¹,Phillips Vivien A.¹¹,Preskitt Julie¹¹,Rector Richard V.¹¹,Stringer Kimberlly¹¹,Whitley Sally¹¹,York Chapman Sheree¹¹,Devaskar Uday¹¹,Garg Meena¹¹,Purdy Isabell B.¹¹,Chanlaw Teresa¹¹,Geller Rachel¹¹,Colaizy Tarah T.¹¹,Widness John A.¹¹,Brumbaugh Jane E.¹¹,Harmon Heidi M.¹¹,Johnson Karen J.¹¹,Schmelzel Mendi L.¹¹,Walker Jacky R.¹¹,Goeke Claire A.¹¹,Eastman Diane L.¹¹,Baack Michelle L.¹¹,Hogden Laurie A.¹¹,Henning Megan M.¹¹,Elenkiwich Chelsey¹¹,Broadbent Megan¹¹,Ellsbury Dan L.¹¹,Bass Donia B.¹¹,Tud Tracy L.¹¹,Fuller Janell¹¹,Ohls Robin K.¹¹,Backstrom Lacy Conra¹¹,Hartenberger Carol¹¹,Sundquist Beauman Sandra¹¹,Hanson Mary¹¹,Lowe Jean R.¹¹,Kuan Elizabeth¹¹,Schmidt Barbara¹¹,Kirpalani Haresh¹¹,Abbasi Soraya¹¹,Chaudhary Aasma S.¹¹,Mancini Toni¹¹,Cucinotta Dara M.¹¹,Bernbaum Judy C.¹¹,Gerdes Marsha¹¹,Ghayam Sarvin¹¹,Hurt Hallam¹¹,Snyder Jonathan¹¹,Ziolkowski Kristina¹¹,D'Angio Carl T.¹¹,Guillet Ronnie¹¹,Myers Gary J.¹¹,Reynolds Anne Marie¹¹,Lakshminrusimha Satyan¹¹,Wadkins Holly I.M.¹¹,Sacilowski Michael G.¹¹,Jensen Rosemary L.¹¹,Merzbach Joan¹¹,Zorn William¹¹,Farooq Osman¹¹,Maffett Dee¹¹,Williams Ashley¹¹,Hunn Julianne¹¹,Guilford Stephanie¹¹,Yost Kelley¹¹,Rowan Mary¹¹,Prinzing Diane¹¹,Wynn Karen¹¹,Bowman Melissa¹¹,Reubens Linda J.¹¹,Scorsone Ann Marie¹¹,Hartley-McAndrew Michelle¹¹,Fallone Caitlin¹¹,Binion Kyle¹¹,Orme Constance¹¹,Sabaratnam Premini¹¹,Kent Alison¹¹,Horihan Cassandra A.¹¹,Jones Rachel¹¹,Boylin Elizabeth¹¹,Rochez Daisy¹¹,Li Emily¹¹,Kachelmeyer Jennifer¹¹,McKee Kimberly G.¹¹,Coleman Kelly R.¹¹,Wyckoff Myra H.¹¹,Brion Luc P.¹¹,Heyne Roy J.¹¹,Vasil Diana M.¹¹,Adams Sally S.¹¹,Chen Lijun¹¹,De Leon Maria M.¹¹,Eubanks Frances¹¹,McDougald Rebecca¹¹,Payageau Lara¹¹,Sepulveda Pollieanna¹¹,Guzman Alicia¹¹,Heyne Elizabeth¹¹,Madden Linda A.¹¹,Lee Lizette E.¹¹,Twell Boatman Cathy¹¹,Vera Azucena¹¹,Waterbury Jillian¹¹,Yoder Bradley A.¹¹,Baserga Mariana¹¹,Faix Roger G.¹¹,Minton Stephen D.¹¹,Sheffield Mark J.¹¹,Rau Carrie A.¹¹,Baker Shawna¹¹,Burnett Jill¹¹,Christensen Susan¹¹,Cunningham Sean D.¹¹,Davis Brandy¹¹,Elmont Jennifer O.¹¹,Hall Becky¹¹,Jensen Erika R.¹¹,Loertscher Manndi C.¹¹,Marchant Trisha¹¹,Maxson Earl¹¹,McGrath Kandace M.¹¹,Mickelsen Hena G.¹¹,Morshedzadeh Galina¹¹,Parry Melody D.¹¹,Schaefer Susan T.¹¹,Stout Kelly¹¹,Stuart Ashley L.¹¹,Weaver-Lewis Kimberlee¹¹,Winter Sarah¹¹,Woodbury Kathryn D.¹¹,Shankaran Seetha¹¹,Natarajan Girija¹¹,Pappas Athina¹¹,Sood Beena G.¹¹,Bajaj Monika¹¹,February Melissa¹¹,Agarwal Prashant¹¹,Chawla Sanjay¹¹,Bara Rebecca¹¹,Childs Kirsten¹¹,Woldt Eunice¹¹,Goldston Laura¹¹,Barks John¹¹,Wiggins Stephanie A.¹¹,Christensen Mary K.¹¹,Carlson Martha¹¹,White Diane F.¹¹,

Affiliation:

1. Division of Neonatology and Department of Pediatrics, Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia

2. Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, North Carolina

3. Department of Pediatrics, University of Texas McGovern Medical School, Houston

4. Neonatal/Perinatal Medicine, Nemours Children’s Hospital, Wilmington, Delaware

5. Department of Pediatrics and Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina

6. Stead Family Department of Pediatrics, University of Iowa, Iowa City

7. Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill

8. University of New Mexico Health Sciences Center, Albuquerque

9. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland

10. Division of Neonatology, University of Utah, Salt Lake City

11. for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

Abstract

ImportanceMeta-analyses suggest that corticosteroids may be associated with increased survival without cerebral palsy in infants at high risk of bronchopulmonary dysplasia (BPD) but are associated with adverse neurologic outcomes in low-risk infants. Whether this association exists in contemporary practice is uncertain because most randomized clinical trials administered corticosteroids earlier and at higher doses than currently recommended.ObjectiveTo evaluate whether the pretreatment risk of death or grade 2 or 3 BPD at 36 weeks’ postmenstrual age modified the association between postnatal corticosteroid therapy and death or disability at 2 years’ corrected age in extremely preterm infants.Design, Setting, and ParticipantsThis cohort study analyzed data on 482 matched pairs of infants from 45 participating US hospitals in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database (GDB). Infants were included in the cohort if they were born at less than 27 weeks’ gestation between April 1, 2011, and March 31, 2017; survived the first 7 postnatal days; and had 2-year death or developmental follow-up data collected between January 2013 and December 2019. Corticosteroid-treated infants were propensity score matched with untreated controls. Data were analyzed from September 1, 2019, to November 30, 2022.ExposureSystemic corticosteroid therapy to prevent BPD that was initiated between day 8 and day 42 after birth.Main Outcomes and MeasuresThe primary outcome was death or moderate to severe neurodevelopmental impairment at 2 years’ corrected age. The secondary outcome was death or moderate to severe cerebral palsy at 2 years’ corrected age.ResultsA total of 482 matched pairs of infants (mean [SD] gestational age, 24.1 [1.1] weeks]; 270 males [56.0%]) were included from 656 corticosteroid-treated infants and 2796 potential controls. Most treated infants (363 [75.3%]) received dexamethasone. The risk of death or disability associated with corticosteroid therapy was inversely associated with the estimated pretreatment probability of death or grade 2 or 3 BPD. The risk difference for death or neurodevelopmental impairment associated with corticosteroids decreased by 2.7% (95% CI, 1.9%-3.5%) for each 10% increase in the pretreatment risk of death or grade 2 or 3 BPD. This risk transitioned from estimated net harm to benefit when the pretreatment risk of death or grade 2 or 3 BPD exceeded 53% (95% CI, 44%-61%). For death or cerebral palsy, the risk difference decreased by 3.6% (95% CI, 2.9%-4.4%) for each 10% increase in the risk of death or grade 2 or 3 BPD and transitioned from estimated net harm to benefit at a pretreatment risk of 40% (95% CI, 33%-46%).Conclusions and RelevanceResults of this study suggested that corticosteroids were associated with a reduced risk of death or disability in infants at moderate to high pretreatment risk of death or grade 2 or 3 BPD but with possible harm in infants at lower risk.

Publisher

American Medical Association (AMA)

Subject

General Medicine

Link

https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2804584/jensen_2023_oi_230382_1682948877.78834.pdf

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