Objectives: Corticosteroids are used to prevent or treat lung disease of prematurity. While neurological side effects have been reported, detailed effects on cerebellar growth are unknown. This... Show moreObjectives: Corticosteroids are used to prevent or treat lung disease of prematurity. While neurological side effects have been reported, detailed effects on cerebellar growth are unknown. This study aimed to compare cerebellar growth in premature infants who received dexamethasone or hydrocortisone to premature infants who did not receive postnatal corticosteroids. Study Design: Retrospective case-control study in infants born at a gestational age of <29 weeks and admitted to two level 3 neonatal intensive care units. Exclusion criteria were severe congenital anomalies and cerebellar or severe supratentorial lesions. Infants were treated with dexamethasone (unit 1) or hydrocortisone (unit 2) for chronic lung disease. Controls (unit 1) did not receive postnatal corticosteroids. Sequential head circumference (HC) and ultrasound measurements of transcerebellar diameter (TCD), biparietal diameter (BPD), and corpus callosum-fastigium length (CCFL) were performed until 40 weeks' postmenstrual age (PMA). Growth was assessed using linear mixed models correcting for PMA at measurement, sex, HC z-score at birth, and a propensity score indicating illness severity. Group differences before treatment were assessed using linear regression. Results: 346 infants were included (68 dexamethasone, 37 hydrocortisone, 241 controls). Before starting corticosteroids, TCD, BPD, and HC measurements did not differ between patients and controls at a comparable PMA. After starting treatment, both types of corticosteroid had a negative association with TCD growth. BPD, CCFL, and HC growth were not negatively affected. Conclusion: Administration of dexamethasone and hydrocortisone are both associated with impaired cerebellar growth in premature infants without evident negative associations with cerebral growth. Show less
Boswinkel, V.; Sok, F.I.; Kruse-Ruijter, M.F.; Nijholt, I.M.; Jansen, F.A.R.; Haak, M.C.; ... ; Wezel-Meijler, G. van 2021
Background: Brain growth in moderate preterm (MP; gestational age (GA) 32(+0)-33(+6) weeks) and late preterm infants (LP; GA 34(+0)-36+6 weeks) may be impaired, even in the absence of brain injury... Show moreBackground: Brain growth in moderate preterm (MP; gestational age (GA) 32(+0)-33(+6) weeks) and late preterm infants (LP; GA 34(+0)-36+6 weeks) may be impaired, even in the absence of brain injury.Aims: The aims of this study were to assess brain measurements of MP and LP infants, and to compare these with full-term infants (GA > 37 weeks) using linear cranial ultrasound (cUS) at term equivalent age (TEA).Study design: cUS data from two prospective cohorts were combined. Two investigators performed offline measurements on standard cUS planes. Eleven brain structures were compared between MP, LP and full-term infants using uni-and multivariable linear regression.Results were adjusted for postmenstrual age at cUS and corrected for multiple testing. Results: Brain measurements of 44 MP, 54 LP and 52 full-term infants were determined on cUS scans at TEA. Biparietal diameter and basal ganglia-insula width were smaller in MP (-9.1 mm and -1.7 mm, p < 0.001) and LP infants (-7.0 mm and -1.7 mm, p < 0.001) compared to full-term infants. Corpus callosum - fastigium length was larger in MP (+2.2 mm, p < 0.001) than in full-term infants. No significant differences were found between MP and LP infants.Conclusions: These findings suggest that brain growth in MP and LP infants differs from full-term infants. Whether these differences have clinical implications remains to be investigated. Show less
