Vor- und Nachteile einer postnatalen Glukokortikosteroidtherapie bei Frühgeborenen

Abstract

Postnatal glucocorticosteroids are commonly used to support weaning of preterm infants from the ventilator and to prevent or treat chronic lung disease (CLD). However, recent follow-up studies have raised concerns that postnatal glucocorticosteroids may cause adverse neuro-developmental outcome. A systematic review of the literature was therefore performed. Data from randomised controlled trials were used to determine the benefits and risks of postnatal glucocorticosteroid treatment in preterm infants. Postnatal glucocorticosteroids reduce duration of mechanical ventilation and the risk of developing CLD without a significant impact on mortality. However, one single study without any “contamination” of the control group revealed a trend towards decreased mortality in the treatment group. Several studies show that postnatal corticosteroid treatment is associated with increased risk for adverse neuro-developmental outcome. Postnatal glucocorticosteroid treatment is associated with short-term benefits and an increased risk for adverse neuro-developmental outcome. Therefore, it should be used only in life-threatening situations.