Methylprednisolone, an alternative to dexamethasone in very premature infants at risk of chronic lung disease

André, P.; Thébaud, B.; Odièvre, M. H.; Razafimahefa, H.; Zupan, V.; Dehan, M.; Lacaze-Masmonteil, T.
October 2000
Intensive Care Medicine;Oct2000, Vol. 26 Issue 10, p1496
Academic Journal
Objective: To evaluate the benefits and the medium-term side effects of methylprednisolone in very preterm infants at risk of chronic lung disease. Study design: Forty-five consecutive preterm infants (<30 weeks' gestation) at risk of chronic lung disease were treated at a mean postnatal age of 16 days with a tapering course of methylprednisolone. The outcome of treatment was assessed by comparison with 45 consecutive historical cases of infants treated with dexamethasone; the infants did not differ in baseline characteristics. Results: There were no differences between groups in the rate of survivors without chronic lung disease. Infants treated with methylprednisolone had a higher rate of body weight gain during the treatment period (median 120 g, range 0 to 190, vs. 70 g, range –110 to 210, P=0.01) and between birth and the age of 40 weeks (median 1660 g, range 1170–2520, vs. 1580 g, range 1040 to 2120, P=0.02). The incidence of both glucose intolerance requiring insulin (0% vs. 18%, P=0.006) and cystic periventricular leukomalacia (2% vs. 18%, P=0.03) was lower among methylprednisolone-treated infants. Conclusion: Our observations confirm methylprednisolone to be as effective as dexamethasone and to have fewer side effects. A randomized control trial is needed to further study the efficacy and safety of methylprednisolone in very premature infants at risk of chronic lung disease.


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