Outcomes in extremely preterm neonates after the introduction of early low-dose hydrocortisone treatment: a retrospective case-control study.
Purcell, Ellie Sachdev, Pooja Batra, Dushyant
Purcell, Ellie
Sachdev, Pooja
Batra, Dushyant
Abstract
OBJECTIVE: Assess the association between use of early low-dose hydrocortisone (ELDH) in extremely preterm neonates, and bronchopulmonary dysplasia (BPD)-free survival at 36 weeks completed gestational age (CGA), as well as additional secondary outcomes.
DESIGN: Retrospective, matched, case-control study.
SETTING: Tertiary neonatal intensive care units in Nottingham University Hospitals NHS Trust (Queens Medical Centre and Nottingham City Hospital).
PATIENTS: 188 extremely preterm neonates. 94 historical controls born between 1 October 2017 and 30 September 2019. 94 cases born between 1 January 2020 and 31 December 2021.
INTERVENTIONS: ELDH using the published PREMILOC study protocol (total dose of 8.5 mg/kg over 10 days) initiated within the first 24 h of life.
PRIMARY OUTCOME MEASURE: Survival without BPD at 36 weeks CGA.
RESULTS: There were no statistically significant associations between the sex, gestational age or birthweight of the groups. There was no significant association between the use of ELDH and increased survival without BPD at 36 weeks CGA (p = 0.153) or reduction in mortality (p = 0.814). Using ELDH was significantly associated with an increased incidence of culture positive late-onset sepsis (p = 0.006), higher non-invasive respiratory support days (p = 0.032) and a longer total length of stay (p = 0.004).
CONCLUSIONS: ELDH use was not associated with an improvement in BPD free survival in extremely preterm neonates. The cases had a higher incidence of culture positive late-onset sepsis and longer duration of respiratory support. Further research exploring stratification of preterm neonates that will benefit from ELDH is needed.
MIDER Authors
Date
2025-12-18
Type
Article
Subject
Infant Newborn, Infant Newborn
Collections
Citation
Purcell E, Sachdev P, Batra D. Outcomes in extremely preterm neonates after the introduction of early low-dose hydrocortisone treatment: A retrospective case-control study. Early Hum Dev. 2026 Mar;214:106463. doi: 10.1016/j.earlhumdev.2025.106463.
Journal / Source Title
Early Human Development
DOI
10.1016/j.earlhumdev.2025.106463
PMID
41442880
Publisher
Elsevier Ireland Ltd