1538 GROWTH FAILURE DURING DEXAMETHASONE THERAPY IN PRETERM NEONATES

Abstract

Recent reports suggest that steroid treatment may improve lung function in infants with chronic lung failure. Glucocorticoid therapy has many potential toxicities, including growth failure. Growth retarding effects have been reported with 200 mg/kg of cortisol. Suggested mechanisms include inhibition of cell mitosis, loss of thymic growth factor, and increased consumption of amino acids by liver. We have noted that growth cruves of ventilator dependent infants were flat during dexamethasone (D) therapy; we retrospectively evaluated 13 such infants 27±2 wks GA, 1057±251 gms b.wt. with chronic lung failure. Parenteral D was started at mean age of 6±2 wks at a dose of 1 mg/kg/day for 4 days and 0.5 mg/kg/day for 6 days. The mean weight of the infants the week prior to treatment was 1346 gms ± 474 and 1420 gm ± 464 at the time D was started. The median daily weight change (gms) prior to and during D therapy are plotted below. This pattern was not related to differences in mean fluid intake or output for the 2 periods. These preliminary data suggest that growth during D may be impaired. Further research is needed to determine if this is a transient or long term effect.