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Steroid treatment offers no benefit in preemies, Hopkins Children's study suggests
Date:10/9/2008

Results of a multicenter study led by Johns Hopkins Children's Center challenge the longstanding practice of treating premature babies with hydrocortisone, a steroid believed to fight inflammation and prevent lung disease. The researchers found that such treatment offers little or no benefit and that low cortisol levels are not even necessarily harmful. High cortisol levels, on the other hand, appeared to increase the risk of dangerous bleeding in the brain and require that babies be monitored aggressively to ward off life-threatening complications, according to the study published in the October issue of Pediatrics.

Premature babies and adults with a condition known as relative adrenal insufficiency have abnormally low levels of the stress hormone cortisol. The standard treatment for this condition in newborns has been hydrocortisone therapy. These findings, however, shed new light on the clinical meaning of low cortisol levels in preemies, showing that contrary to common belief, low blood concentrations of this hormone do not put extremely low-birth-weight babies (those born weighing less than 2.2 pounds) at higher risk for retinopathy of prematurity a potentially blinding eye condition inflammation and lung disease.

Researchers also found no difference in health outcomes between babies with low cortisol levels who were treated with hydrocortisone and those given a placebo. While hydrocortisone had no adverse effects on a baby's health, it also did nothing to prevent or reduce respiratory diseases, infections, hemorrhages or retinopathy.

"We were intrigued and somewhat surprised, but contrary to what we expected, low cortisol levels do not appear to be dangerous and may actually be the norm in premature babies," said study lead investigator Susan Aucott, M.D., a neonatologist at Hopkins Children's. "What this means is we should really think twice before rushing to treatment with hydrocortisone in our effort to 'correct' t
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Contact: Katerina Pesheva
epeshev1@jhmi.edu
410-516-4996
Johns Hopkins Medical Institutions
Source:Eurekalert

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