Prophylactic hydrocortisone in extremely preterm infants and brain MRI abnormality
| Autor: | Alison, Marianne, Tilea, Bogdana, Toumazi, Artemis, Biran, Valérie, Mohamed, Damir, Alberti, Corinne, Bourmaud, Aurélie, Baud, Olivier, PREMILOC Trial group |
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| Přispěvatelé: | AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Maladies neurodéveloppementales et neurovasculaires (NeuroDiderot (UMR_S_1141 / U1141)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Hopital Robert Debre, Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpitaux Universitaires de Genève (HUG), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Salvy-Córdoba, Nathalie, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Hydrocortisone MESH: Logistic Models Gastroenterology MESH: Magnetic Resonance Imaging MESH: Dose-Response Relationship Drug 0302 clinical medicine MESH: Bronchopulmonary Dysplasia Bronchopulmonary Dysplasia ddc:618 MESH: Infant Extremely Premature MESH: Infant Newborn Confounding Brain Obstetrics and Gynecology General Medicine Magnetic Resonance Imaging MESH: Hydrocortisone medicine.anatomical_structure Infant Extremely Premature Female medicine.symptom Abnormality medicine.drug medicine.medical_specialty Brain damage Placebo White matter MESH: Brain 03 medical and health sciences [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics 030225 pediatrics Internal medicine medicine Humans MESH: Neurodevelopmental Disorders [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics MESH: Humans Dose-Response Relationship Drug business.industry Infant Newborn Postmenstrual Age medicine.disease MESH: Male Logistic Models Bronchopulmonary dysplasia Neurodevelopmental Disorders Brain Injuries Intensive care MESH: Brain Injuries Pediatrics Perinatology and Child Health Neonatology business MESH: Female 030217 neurology & neurosurgery |
| Zdroj: | Archives of Disease in Childhood Fetal and Neonatal Edition (2020) Archives of disease in childhood. Fetal and neonatal edition Archives of disease in childhood. Fetal and neonatal edition, BMJ Publishing Group, 2020, 105 (5), pp.520-525. ⟨10.1136/archdischild-2019-317720⟩ Archives of disease in childhood.Fetal and neonatal edition Archives of disease in childhood.Fetal and neonatal edition, BMJ Publishing Group, 2020, 105 (5), pp.520-525. ⟨10.1136/archdischild-2019-317720⟩ |
| ISSN: | 2007-0020 1359-2998 1468-2052 |
| DOI: | 10.1136/archdischild-2019-317720⟩ |
| Popis: | ObjectiveTo determine whether early low-dose hydrocortisone treatment in extremely preterm infants is associated with brain damage assessed by MRI at term equivalent of age (TEA).Patients and outcomesThis is a predefined secondary analysis of brain abnormalities, observed by MRI at TEA, of patients randomly assigned to receive either placebo or hydrocortisone in the PREMILOC trial. Outcomes were based on brain abnormalities graded according to Kidokoro scores.ResultsAmong 412 survivors at TEA, 300 MRIs were performed and 295 were suitable for analysis. Kidokoro scoring was completed for 119/148 and 110/147 MRIs in the hydrocortisone and placebo groups, respectively. The distribution of the Kidokoro white matter (WM) subscore and other subscores was not significantly different between the two groups. There was, however, a significant association between a higher overall Kidokoro score and hydrocortisone treatment (5.84 (SD 3.51) for hydrocortisone and 4.98 (SD 2.52) for placebo; mean difference, 0.86; 95% CI 0.06 to 1.66; p=0.04). However, hydrocortisone was not statistically associated with moderate-to-severe brain lesions (Kidokoro overall score ≥6) in a multivariate logistic regression model accounting for potential confounding variables (adjusted OR (95% CI) 1.27 (0.75 to 2.14), p=0.38). Bronchopulmonary dysplasia at 36 weeks postmenstrual age significantly predicted both WM damage (adjusted OR (95% CI) 2.70 (1.03 to 7.14), p=0.04) and global brain damage (adjusted OR (95% CI) 2.18 (1.19 to 3.99), p=0.01).ConclusionsEarly hydrocortisone exposure in extremely preterm infants is not statistically associated with either WM brain damage or overall moderate-to-severe brain lesions when adjusted for other neonatal variables.Trial registration numberEudraCT number 2007-002041-20, NCT00623740 |
| Databáze: | OpenAIRE |
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