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The Use of Two or More Courses of Low-Dose Systemic Dexamethasone to Extubate Ventilator-Dependent Preterm Neonates May Be Associated with a Higher Prevalence of Cerebral Palsy at Two Years of Corrected Age.

2024-07Text Open access
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dc.contributor.authorRocha, Gustavo
dc.contributor.authorCalejo, Rita
dc.contributor.authorArnet, Vanessa
dc.contributor.authorLima, Filipa Flôr
dc.contributor.authorCassiano, Gonçalo
dc.contributor.authorDiogo, Isabel
dc.contributor.authorMesquita, Joana
dc.contributor.authorMimoso, Gabriela
dc.contributor.authorProença, Elisa
dc.contributor.authorCarvalho, Carmen
dc.contributor.authorPinto, Constança Gouvêa
dc.contributor.authorSalazar, Anabela
dc.contributor.authorAguiar, Marta
dc.contributor.authorSilva, Albina
dc.contributor.authorBarroso, Almerinda
dc.contributor.authorQuintas, Conceição
dc.date.accessioned2025-07-25T11:38:30Z
dc.date.available2025-07-25T11:38:30Z
dc.date.issued2024-07
dc.description.abstractBackground: Our objective was to determine whether the use of two or more courses of low-dose systemic dexamethasone for extubation of ventilator-dependent preterm infants after the first week of life, as proposed in the DART study, is associated with greater neurodevelopmental harm at two years of corrected age, compared to a single course. Methods: Retrospective review at seven level III neonatal intensive care units. Preterm infants who underwent only one course of systemic dexamethasone for extubation were grouped into DART-1; those who underwent two or more courses were grouped into DART-2. Data and outcomes of infants in DART-2 were compared with those in DART-1. Results: 150 preterm infants were studied: 104 in DART-1 and 46 in DART-2. Patients in DART-2 had a lower gestational age (25 vs. 26 weeks, p = 0.031) and greater morbidity. The average dexamethasone cumulative dose for patients in DART-1 was 0.819 mg/kg, vs. 1.697 mg/kg for patients in DART-2. A total of 14 patients died. The neuromotor and neurosensory assessments at two years of corrected age revealed in the DART-2 survivors, after the multivariate analysis, a higher prevalence of cerebral palsy with functional motor class 2 (OR = 6.837; 95%CI: 1.054-44.337; p = 0.044) and ophthalmological problems requiring the use of glasses (OR = 4.157; 95%CI: 1.026-16.837; p = 0.046). Conclusions: In this cohort, the use of more than one course of systemic dexamethasone in low doses for extubation of ventilator-dependent premature infants after the first week of life was associated, at two years of corrected age, with a higher prevalence of cerebral palsy with functional motor class 2 and ophthalmological problems requiring the use of glasses.eng
dc.identifier.citationEarly Hum Dev . 2024 Jul:194:106050.
dc.identifier.doi10.1016/j.earlhumdev.2024.106050
dc.identifier.other38781715
dc.identifier.urihttp://hdl.handle.net/10400.17/5122
dc.language.isoen
dc.peerreviewedyes
dc.publisherElsevier
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectAirway Extubation
dc.subjectCerebral Palsy* / epidemiology
dc.subjectChild
dc.subjectPreschool
dc.subjectDexamethasone* / administration & dosage
dc.subjectDexamethasone* / adverse effects
dc.subjectInfant
dc.subjectNewborn
dc.subjectPremature*
dc.subjectPrevalence
dc.subjectRespiration
dc.subjectArtificial
dc.subjectRetrospective Studies
dc.subjectMAC UCI NEO
dc.titleThe Use of Two or More Courses of Low-Dose Systemic Dexamethasone to Extubate Ventilator-Dependent Preterm Neonates May Be Associated with a Higher Prevalence of Cerebral Palsy at Two Years of Corrected Age.por
dc.typetext
dspace.entity.typePublication
oaire.citation.startPage106050
oaire.citation.volume194
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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