Association of Postnatal Corticosteroids and Effects of Neurodevelopment in Low Birth Weight Infants in Taiwan

• Main Authors: Tzu-LingKuo, 郭姿伶
• Other Authors: Ching-Lan Cheng
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/wan7zk

碩士 === 國立成功大學 === 臨床藥學與藥物科技研究所 === 102 === The American Academy of Pediatrics recommended that use of postnatal corticosteroid treatment with bronchopulmonary dysplasia (BPD) in preterm infants should be judgment on the potential side effect of impaired neurodevelopment. The aim of this study was to analyze the trend in the use of postnatal corticosteroid over a 12-year period in preterm infants in Taiwan, and discuss the relationship between postnatal corticosteroids use and neurodevelopment. We used population-based nationwide claim database from 1999 to 2010 as materials. The data were analyzed using the Cochran-Armitage trend test, chi-square for categorical variable, t-test for continuous variable, cox proportional hazard model for risk adjustment and statistical significance was indicated by a p-value 〈 0.05. A total of 73,606 infants with 5,325 postnatal corticosteroid prescriptions were analyzed. The overall prescription rate of steroids for infants decreased from 9.2% in 1999 to 5.5% in 2010 (P〈0.0001). The overall prescription trend were similar in subgroup analysis. The use of postnatal corticosteroid did had a 1.65 times increased risk of cerebral palsy event compared to non-users. Inhaled steroid has 52% less risk than systemic steroid in cerebral palsy rate, adjusted HR 0.48 [95% CI: 0.32-0.74], P=0.0007. There was no statistically significant difference in safety of hydrocortisone use when compared to dexamethasone, adjusted HR 0.86 [95% CI: 0.63-1.18], P=0.3398. The prevalence of postnatal steroid prescriptions in Taiwan had decreased. There did has some relationship between the use of postnatal corticosteroid and increase cerebral palsy risk.