The Impact of Postnatal Systemic Steroids on the Growth of Preterm Infants: A Multicenter Cohort Study

Zozaya, Carlos; Ávila-Álvarez, Alejandro; Rodrigo, Fermín García‐Muñoz; Couce, María L.; Arruza, Luis; Fernández‐Pérez, Cristina; Castro, Abdón; Cuesta, María Teresa Cuervo; Vacas, Beatriz; Vento, Máximo; Pipaón, Miguel Sáenz de

doi:10.3390/nu11112729

Cited by 9 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent studies have shown that administering postnatal steroids, either single or multiple courses, has no effect on the growth of premature infants with bronchopulmonary dysplasia (BPD) [20][21][22]. However, to ensure that the use of postnatal steroids did not influence the observed results, we analyzed the data after eliminating the infants exposed to postnatal steroids.…”

Section: Discussionmentioning

confidence: 99%

Association between Weight for Length and the Severity of Respiratory Morbidity in Preterm Infants

Alur,

Harvey,

Hart

et al. 2024

Children

View full text Add to dashboard Cite

Association Between Weight for Length and the Severity of Respiratory Morbidity in Preterm Infants. Objective: To determine whether higher weight-to-length z-scores after 32 weeks of gestation are associated with higher pulmonary scores (PSs) in preterm infants requiring respiratory support using a prospective observational study. Methods: Infants born at <30 weeks, with a post-menstrual age (PMA) of 30–33 weeks, were enrolled. The infant’s weight, length, and head circumference were measured weekly. Data on calories/kg/d, protein g/kg/d, weight-for-length percentiles, z-scores, and BMI at 33 through 40 weeks PMA were collected. The PS was calculated. Results: We analyzed 91 infants. The mean gestational age was 26.9 ± 1.7 weeks. The mean birthweight was 0.898 ± 0.238 kgs. They were predominantly African American (81.3%) and girls (56%). Postnatal steroids were administered in 26.4% of the infants. The mean duration of invasive ventilation was 19.23 days ± 28.30 days. There was a significant association between the PS and W/L z-score (p < 0.0001). For every one-unit increase in W/L z-score, the PS increased by 0.063. There was a significant association between the PS and W/L percentile (p = 0.0017), as well as BMI (p ≤ 0.0001). For every unit increase in W/L percentile, the PS increased by 0.002, and for a unit increase in BMI, the PS increased by 0.04. The association remained significant after postnatal steroid use, sex, and corrected and birth gestational ages were included in the regression analysis. Nutrition did not affect the anthropometric measurements. Conclusions: Our study is the first to demonstrate that a higher BMI and W/L may adversely affect the respiratory severity in preterm infants. Studies with larger sample sizes are needed to confirm our findings.

show abstract

Section: Discussionmentioning

confidence: 99%

Association between Weight for Length and the Severity of Respiratory Morbidity in Preterm Infants

Alur,

Harvey,

Hart

et al. 2024

Children

View full text Add to dashboard Cite

show abstract

“…Nevertheless, plasma cortisol levels were still significantly higher in the APT Group while there was no significant difference in ACTH ( Table 3 ). Although it is not clear that excessive cortisol solely influences fetal growth ( Zozaya et al, 2019 ), it has been reported that the use of hydrocortisone in neonates is associated with growth abnormalities and interferes with the GH–IGF-1 axis at the hypothalamic, pituitary, and target organ levels ( Hochberg, 2002 ; Tijsseling et al, 2018 ). Thus, optimizing the use of glucocorticoids may also be an important consideration in future studies.…”

Section: Discussionmentioning

confidence: 99%

Artificial placenta support of extremely preterm ovine fetuses at the border of viability for up to 336 hours with maintenance of systemic circulation but reduced somatic and organ growth

Usuda,

Ikeda,

Watanabe

et al. 2023

Front. Physiol.

View full text Add to dashboard Cite

Introduction: Artificial placenta therapy (APT) is an experimental life support system to improve outcomes for extremely preterm infants (EPI) less than 1,000 g by obviating the need for pulmonary gas exchange. There are presently no long-term survival data for EPI supported with APT. To address this, we aimed to maintain 95d-GA (GA; term-150d) sheep fetuses for up to 2 weeks using our APT system.Methods: Pregnant ewes (n = 6) carrying singleton fetuses underwent surgical delivery at 95d GA. Fetuses were adapted to APT and maintained for up to 2 weeks with constant monitoring of key physiological parameters and extensive time-course blood and urine sampling, and ultrasound assessments. Six age-matched in-utero fetuses served as controls. Data were tested for group differences with ANOVA.Results: Six APT Group fetuses (100%) were adapted to APT successfully. The mean BW at the initiation of APT was 656 ± 42 g. Mean survival was 250 ± 72 h (Max 336 h) with systemic circulation and key physiological parameters maintained mostly within normal ranges. APT fetuses had active movements and urine output constantly exceeded infusion volume over the experiment. At delivery, there were no differences in BW (with edema in three APT group animals), brain weight, or femur length between APT and in-utero Control animals. Organ weights and humerus lengths were significantly reduced in the APT group (p < 0.05). Albumin, IGF-1, and phosphorus were significantly decreased in the APT group (p < 0.05). No cases of positive blood culture were detected.Conclusion: We report the longest use of APT to maintain extremely preterm fetuses to date. Fetal systemic circulation was maintained without infection, but growth was abnormal. This achievement suggests a need to focus not only on cardiovascular stability and health but also on the optimization of fetal growth and organ development. This new challenge will need to be overcome prior to the clinical translation of this technology.

show abstract

“…Human milk composition was also not chemically analysed, limiting the information about actual intake. Additional confounding factors that could have influenced growth include comorbidities [eg, patent ductus arteriosus (9)], micronutrient intake (12,28,29), steroid exposure (30,31), and the extent to which kangaroo mother care (32) was practiced.…”

Section: Discussionmentioning

confidence: 99%

In‐hospital Growth of Very Low Birth Weight Preterm Infants

Kemp

Becker

Wenhold

2021

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

Objective: Amidst a high prevalence of prematurity, limited research on the growth of very low birth weight (VLBW) preterm infants and the availability of a reformulated fortifier c(RF), the study aimed to compare in-hospital growth of such infants receiving exclusively human milk fortified with either of 2 different formulations in a tertiary South African hospital. Methods: In a prospective comparative effectiveness design, intakes and growth of VLBW infants on the Original Fortifier (OF; 2016–2017) were compared with those receiving RF (2017–2018). Daily intake was calculated using published composition of preterm and mature milk with fortifier (OF: 0.2 g protein, 3.5kcal/g powder; RF: 0.4 g protein, 4.4 kcal/g powder). Change in z scores from start to end of fortification for weight (WFAZ), length (LFAZ), and head circumference (HCFAZ) for age was the primary outcome. Additionally, weight gain velocity (g · kg−1 · day−1) and gain in length and head circumference (HC) (cm/week) were calculated. Results: Fifty-eight infants (52% girls; gestational age: 30 ± 2 weeks; birth weight: 1215 ± 187 g) received OF for 16 days and 59 infants (56% girls; gestational age: 29 ± 2 weeks; birth weight 1202 ± 167 g) received RF for 15 days. Protein intake of RF (3.7 ± 0.4 g · kg−1 · day−1) was significantly higher (P < 0.001) than of OF (3.4 ± 0.2 g · kg−1 · day−1). Protein-to-energy ratio of RF (2.6 ± 0.2 g/100 kcal) was significantly higher (P < 0.001) than of OF (2.3 ± 0.1 g/100 kcal). In both groups, WFAZ and LFAZ decreased; HCFAZ improved slightly. No significant differences (P > 0.05) were noted between the 2 groups for change in z scores, weight gain velocity, length or HC gain. Conclusions: Despite a modest increase in protein intake and protein-to-energy ratio, the growth of VLBW infants on RF was not better than on OF during their hospital stay.

show abstract

The Impact of Postnatal Systemic Steroids on the Growth of Preterm Infants: A Multicenter Cohort Study

Cited by 9 publications

References 28 publications

Association between Weight for Length and the Severity of Respiratory Morbidity in Preterm Infants

Association between Weight for Length and the Severity of Respiratory Morbidity in Preterm Infants

Artificial placenta support of extremely preterm ovine fetuses at the border of viability for up to 336 hours with maintenance of systemic circulation but reduced somatic and organ growth

In‐hospital Growth of Very Low Birth Weight Preterm Infants

Contact Info

Product

Resources

About