Prior research has found that high-dose steroids may interfere with cerebellum growth, Tam said. Previous research has also found that children given steroids right after birth are more prone to learning and behavioral problems, said Dr. Pierre Gressens, a professor of perinatal neurology at the Centre for the Developing Brain at Imperial College in London and a lab chief at INSERM in Paris.
The American Academy of Pediatrics recommends avoiding high-dose dexamethasone in babies after birth, according to background information in the study.
In practice, some hospitals never use steroids in premature babies, while others routinely give steroids, Gressens said. In the study, about 20 percent of the 172 babies had been given steroids post-birth, Tam said.
The new research suggests that steroids should be given after birth only with the utmost caution, carefully balancing potential risks and benefits, Gressens said.
"There are situations where steroids are useful for a short time for the lungs, but doctors have to remember there is a particular toxicity of this steroid," Gressens said.
Tam agreed that doctors should be very cautious in giving steroids to premature babies.
"Even a low dose of dexamethasone or hydrocortisone are associated with decreased brain development, which would make us need to be careful when using these drugs," she said.
"They are very effective drugs," she continued. "We wouldn't want to say don't use them entirely, because we don't have very good alternatives. But when you think about options, don't jump straight to the steroid. You always have to think about the risk and benefit balance. Now there's more risk they have to consider when they think about using this drug."
Tam and her colleagues plan to follow the children as they get older to see if the smaller cerebellums result in motor, learning or behavioral issues.
In a second study, also led by UCS
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