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KMID : 0361720150260040321
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Korean Journal of perinatology
2015 Volume.26 No. 4 p.321 ~ p.328
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Characteristics of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants according to the Timing of Dexamethasone Administration
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이해연:Lee Hae-Yun
:이형진/고지원:Koh Ji-Won/송인규:Song In-gu/김세연:Kim Sae-Yun/정영화:Jung Young-Hwa/신승한:Shin Seung-Han/최창원:Choi Chang-Won/김이경:Kim Ee-Kyung/김한석:Kim Han-Suk/김병일:Kim Beyong-Il/최중환:Choi Jung-Hwan
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Abstract
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Purpose: Corticosteroids has been used for treatment and prophylaxis of bronchopulmonary dysplasia (BPD) in preterm infants. However, administration of corticosteroids could be delayed due to its potential harmful effects on neurodevelopment. The aim of this study was to evaluate the adequate dexamethasone administration timing in very low birth weight infants.
Methods: Medical records of 56 VLBW infants who were admitted to neonatal intensive care unit of Seoul National University Children’s Hospital and Seoul National University Bundang Hospital between January 2008 and September 2014 were collected retrospectively. Study population were divided into early administration group (dexamethasone administration before 4 weeks of postnatal days) and late administration group (after 4 weeks) and respiratory morbidities were compared between groups.
Results: There were no significant differences in clinical characteristics between early administration group (n=30) and late administration group (n=26). Respiratory severity score and oxygen needs at 7 days after birth and before administering dexamethasone were comparable. Extubation was done earlier postnatal days in early administration group. Incidence of severe BPD was higher in the late administration group. There was no significant difference in diagnosed with cerebral palsy (CP) at 12 months of corrected age. When adjusting for multiple risk factors, administration of dexamethasone 4 weeks after birth and severe of BPD showed a significant association (adjusted OR 17.14 [1.29-227.52], P=0.031).
Conclusion: Administration of dexamethasone in order to minimize ventilator care and to reduce severe BPD might be done between 1 week and 4 weeks after birth in very low birth weight infants.
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KEYWORD
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Very low birth weight, Bronchopulmonary dysplasia, Dexamethasone, Cerebral palsy
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