15^th International Conference On Pediatrics and Pediatric Cardiology

Biography

Biography: YoungAh Youn

Abstract

Since corticosteroids are broadly administered, particularly on neurological outcomes, remain a concern. Hypotension and shock within the first week of life for VLBWI are the first indications of circulatory collapse that might require treatment with steroids. Postnatal administration of dexamethasone in preterm infants has been adopted with caution due to its adverse long-term outcomes. Since 2012, our unit has only used hydrocortisone as an alternative to dexamethasone in an attempt to minimize negative long-term neurological outcomes. We examined whether hydrocortisone exposure ≤ 1week in very low birth weight infants (VLBWI) was associated with poor neurodevelopmental outcomes at corrected 18 months. Of a total of 191 VLBWI, 115 (60.2%) infants were exposed to early postnatal hydrocortisone ≤ 1 week of life in our NICU of Seoul St. Mary’s Hospital, The Catholic University of Korea between December 2012 and December 2014. The morbidities were significantly higher in the group with early hydrocortisone exposure group. At corrected age of 18 months, 183 (95.8%) infants in the early hydrocortisone exposure group had significantly lower scores in all three (cognitive, language and motor) composites of Bayley Scales of Infant and Toddler Development III. The multivariable logistic regression analysis showed that periventricular leukomalacia (PVL) is consistently associated with poor long-term outcomes. Our results suggest that early hydrocortisone exposure ≤ 1week in VLBWI may not increase the risk for poor long-term outcomes compared to those not exposed. Only PVL is considered as a risk factor for poor long-term neurodevelopmental outcomes.