Early Low-Dose Hydrocortisone for Extremely Preterm Infants

Prophylactic treatment for the first 10 days of life improved survival without bronchopulmonary dysplasia and did not increase risk for intestinal perforation.

Bronchopulmonary dysplasia, a major morbidity of extreme prematurity (<28 weeks gestation), has been associated with low cortisol concentrations after birth. However, previous trials of early preventive hydrocortisone therapy were unsuccessful and linked to increased rates of intestinal perforation.

To further examine the efficacy and safety of this treatment strategy, French investigators conducted a multicenter, prospective, randomized, double-blind trial (PREMILOC), in which 523 extremely preterm infants (<28 weeks gestation) received placebo or hydrocortisone (1 mg/kg/day for 7 days followed by 0.5 mg/kg/day for 3 days). Ibuprofen treatment for patent ductus arteriosus was excluded during the first 24 hours of life. Financial and technic…

Reviewing Author

Robin Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Robin Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Early Low-Dose Hydrocortisone for Extremely Preterm Infants

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Reviewing Author