The American Academy of Pediatrics recently revised its policy statement on the use of postnatal corticosteroids for the management or prevention of chronic lung disease following preterm birth (formerly referred to as bronchopulmonary dysplasia). Based on several prospective randomized trials published since the 2010 update, AAP writes: “High-dose dexamethasone (≥0.5 mg/kg per day) is not recommended. New evidence suggests that inhaled corticosteroids may confer benefit if provided with surfactant as a vehicle, but safety data are lacking. Evidence remains insufficient to make any recommendations regarding routine use of postnatal corticosteroids in preterm infants. Neonatologists and other hospital care providers must continue to use their clinical judgment in individual patients, balancing the potential adverse effects of corticosteroid treatment with those of chronic lung disease. The decision to use postnatal corticosteroids for this purpose should be made together with the infant’s parents, and the care providers should document their discussions with parents in the patient’s medical record.”
