Steroid treatment for premature babies offers no benefit

Washington, Oct 10 : The practice of treating premature babies with hydrocortisone, a steroid believed to fight inflammation and prevent lung disease, offers little or no benefit, according to the latest research.

High cortisol levels, on the other hand, appeared to increase the risk of dangerous bleeding in the brain and require that babies be monitored aggressively to ward off life-threatening complications, according to the study led by Johns Hopkins Children's Centre.

"We were intrigued and somewhat surprised, but contrary to what we expected, low cortisol levels do not appear to be dangerous and may actually be the norm in premature babies," said the study's lead investigator Susan Aucott, a neonatologist at Hopkins.

"What this means is we should really think twice before rushing to treatment with hydrocortisone in our effort to 'correct' these low levels," said Pamela Donahue, a co-investigator of the study.

Premature babies and adults with a condition known as relative adrenal insufficiency have abnormally low levels of the stress hormone cortisol. The standard treatment for this condition in newborns has been hydrocortisone therapy, according to John Hopkins press release.

These findings, however, shed new light on the clinical meaning of low cortisol levels in premature babies, showing that contrary to belief, low blood concentrations of this hormone do not put extremely low-birth-weight babies (less than 1.1 kg) at higher risk for retinopathy of prematurity - a potentially blinding eye condition, inflammation and lung disease.

Comparing the cortisol levels of 311 extremely low-birth-weight preemies immediately after birth and one week after birth, researchers found low cortisol levels did not increase the risk for adverse short-term outcomes or death.

Babies with moderately to severely elevated cortisol levels at birth and shortly after birth had a higher risk for life-threatening brain bleeds, dangerous gastrointestinal perforations and severe retinopathy, researchers found.

These findings were published in the October issue of Paediatrics.