{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T20:09:40Z","timestamp":1774123780324,"version":"3.50.1"},"reference-count":52,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,3,1]]},"abstract":"<jats:p>OBJECTIVE. Postnatal steroid use decreases lung inflammation but increases impairment. We hypothesized that increased dose is associated with increased neurodevelopmental impairment, lower postmenstrual age at exposure increases impairment, and risk of bronchopulmonary dysplasia modifies the effect of postnatal corticosteroid.<\/jats:p><jats:p>METHODS. Steroid dose and timing of exposure beyond 7 days was assessed among 2358 extremely low birth weight infants nested in a prospective trial, with 1667 (84%) survivors examined at 18 to 22 months' postmenstrual age. Logistic regression tested the relationship between impairment (Bayley Mental Developmental Index\/Psychomotor Developmental Index of &amp;lt;70, disabling cerebral palsy, or sensory impairment), total dose (tertiles: &amp;lt;0.9, 0.9\u20131.9, and \u22651.9 mg\/kg), and postmenstrual age at first dose. Separate logistic regression tested effect modification according to bronchopulmonary dysplasia severity (Romagnoli risk &amp;gt; 0.5 as high risk, n = 2336 (99%) for days of life 4\u20137).<\/jats:p><jats:p>RESULTS. Three hundred sixty-six (16%) neonates were steroid-treated (94% dexamethasone). Treated neonates were smaller and less mature; 72% of those treated were at high risk for bronchopulmonary dysplasia. Exposure was associated with neurodevelopmental impairment\/death. Impairment increased with higher dose; 71% dead or impaired at highest dose tertile. Each 1 mg\/kg dose was associated with a 2.0-point reduction on the Mental Developmental Index and a 40% risk increase for disabling cerebral palsy. Older age did not mitigate the harm. Treatment after 33 weeks' postmenstrual age was associated with greatest harm despite not receiving the highest dose. The relationship between steroid exposure and impairment was modified by the bronchopulmonary dysplasia risk, with those at highest risk experiencing less harm.<\/jats:p><jats:p>CONCLUSIONS. Higher steroid dose was associated with increased neurodevelopmental impairment. There is no \u201csafe\u201d window for steroid use in extremely low birth weight infants. Neonates with low bronchopulmonary dysplasia risk should not be exposed. A randomized trial of steroid use in infants at highest risk is warranted.<\/jats:p>","DOI":"10.1542\/peds.2008-1928","type":"journal-article","created":{"date-parts":[[2009,2,10]],"date-time":"2009-02-10T01:34:57Z","timestamp":1234229697000},"page":"e430-e437","source":"Crossref","is-referenced-by-count":101,"title":["Impact of Postnatal Corticosteroid Use on Neurodevelopment at 18 to 22 Months' Adjusted Age: Effects of Dose, Timing, and Risk of Bronchopulmonary Dysplasia in Extremely Low Birth Weight Infants"],"prefix":"10.1542","volume":"123","author":[{"given":"Deanne","family":"Wilson-Costello","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele C.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Langer","sequence":"additional","affiliation":[{"name":"Department of Statistics, Research Triangle Institute, Research Triangle Park, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronnie","family":"Guillet","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Rochester, Rochester, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbot R.","family":"Laptook","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Texas Southwestern, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara J.","family":"Stoll","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seetha","family":"Shankaran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wayne State University, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil N.","family":"Finer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krisa P.","family":"Van Meurs","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stanford University, Palo Alto, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Engle","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhik","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Statistics, Research Triangle Institute, Research Triangle Park, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2009,3,1]]},"reference":[{"key":"2021120902492003300_R1","doi-asserted-by":"crossref","unstructured":"Halliday HL, Ehrenkranz RA, Doyle LW. Early postnatal (&lt;96 hours) corticosteroids for preventing chronic lung disease in preterm infants [Cochrane review]. In: The Cochrane Library. Issue 1. Chichester, United Kingdom: John Wiley and Sons; 2004","DOI":"10.1002\/14651858.CD001146"},{"key":"2021120902492003300_R2","doi-asserted-by":"crossref","unstructured":"Halliday HL, Ehrenkranz RA, Doyle LW. Moderately early (7\u201314 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants [Cochrane review]. In: The Cochrane Library. Issue 1. Chichester, United Kingdom: John Wiley and Sons; 2004","DOI":"10.1002\/14651858.CD001144"},{"key":"2021120902492003300_R3","doi-asserted-by":"crossref","unstructured":"Halliday HL, Ehrenkranz RA, Doyle LW. Delayed (&gt;3 weeks) postnatal corticosteroids for preventing chronic lung disease in preterm infants [Cochrane review] In: The Cochrane Library. Issue 1. Chichester, United Kingdom: John Wiley and Sons; 2004","DOI":"10.1002\/14651858.CD001145"},{"key":"2021120902492003300_R4","unstructured":"Stark AR, Carlo WA, Tyson JE, et al. Adverse effects of early dexamethasone in extremely-low-birth-weight infants: Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. N Engl J Med.\u20082001;344(2):95\u2013101"},{"key":"2021120902492003300_R5","doi-asserted-by":"crossref","unstructured":"Stoll BJ, Temprosa M, Tyson J, et al. Dexamethasone therapy increases infection in very low birth weight infants. Pediatrics.\u20081999;104(5). Available at: www.pediatrics.org\/cgi\/content\/full\/104\/5\/e63","DOI":"10.1542\/peds.104.5.e63"},{"key":"2021120902492003300_R6","doi-asserted-by":"crossref","unstructured":"Barrington KJ. The adverse neuro-developmental effects of postnatal steroids in the preterm infant: a systematic review of RCTs. BMC Pediatr.\u20082001;1:1","DOI":"10.1186\/1471-2431-1-1"},{"key":"2021120902492003300_R7","doi-asserted-by":"crossref","unstructured":"Shinwell ES, Karplus M, Reich D, et al. Early postnatal dexamethasone treatment and increased incidence of cerebral palsy. Arch Dis Child Fetal Neonatal Ed.\u20082000;83(3):F177\u2013F181","DOI":"10.1136\/fn.83.3.F177"},{"key":"2021120902492003300_R8","doi-asserted-by":"crossref","unstructured":"Murphy BP, Indur TE, Huppi PS, et al. Impaired cerebral cortical gray matter growth after treatment with dexamethasone for neonatal chronic lung disease. Pediatrics.\u20082001;107(2):217\u2013221","DOI":"10.1542\/peds.107.2.217"},{"key":"2021120902492003300_R9","doi-asserted-by":"crossref","unstructured":"Haroon Parupia P, Dhanireddy R. Association of postnatal dexamethasone use and fungal sepsis in the development of severe retinopathy of prematurity and progression to laser therapy in extremely low-birth-weight infants. J Perinatol.\u20082001;21(4):242\u2013247","DOI":"10.1038\/sj.jp.7200531"},{"key":"2021120902492003300_R10","doi-asserted-by":"crossref","unstructured":"Short EJ, Klein NK, Lewis BA, et al. Cognitive and academic consequences of bronchopulmonary dysplasia and very low birth weight: 8-year-old outcomes. Pediatrics.\u20082003;112(5). Available at: www.pediatrics.org\/cgi\/content\/full\/112\/5\/e359","DOI":"10.1542\/peds.112.5.e359"},{"key":"2021120902492003300_R11","doi-asserted-by":"crossref","unstructured":"LeFlore JL, Salhab WA, Broyles RS, Engle WD. Association of antenatal and postnatal dexamethasone exposure with outcomes in extremely low birth weight neonates. Pediatrics.\u20082002;110(2 pt 1):275\u2013279","DOI":"10.1542\/peds.110.2.275"},{"key":"2021120902492003300_R12","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Fetus and Newborn and Canadian Paediatric Society, Fetus and Newborn Committee. Postnatal corticosteroids to treat or prevent chronic lung disease in preterm infants. Pediatrics.\u20082002;109(2):330\u2013338","DOI":"10.1542\/peds.109.2.330"},{"key":"2021120902492003300_R13","doi-asserted-by":"crossref","unstructured":"Kaempf JW, Campbell B, Sklar RS, et al. Implementing potentially better practices to improve neonatal outcomes after reducing postnatal dexamethasone use in infants born between 501 and 1250 grams. Pediatrics.\u20082003;111(4 pt 2). Available at: www.pediatrics.org\/cgi\/content\/full\/111\/4\/e534","DOI":"10.1542\/peds.111.SE1.e534"},{"key":"2021120902492003300_R14","doi-asserted-by":"crossref","unstructured":"Doyle LW, Davis PG, Morley CJ, McPhee A, Carlin JB; DART Study Investigators. Low dose dexamethasone facilitates extubation among critically ventilator-dependent infants: a multicenter, international, randomized, controlled trial. Pediatrics.\u20082006;117(1):75\u201383","DOI":"10.1542\/peds.2004-2843"},{"key":"2021120902492003300_R15","doi-asserted-by":"crossref","unstructured":"Doyle LW, Halliday HL, Ehrenkranz RA, Davis PG, Sinclair JC. Impact of postnatal systemic corticosteroids on mortality and cerebral palsy in preterm infants: effect modification by risk for chronic lung disease. Pediatrics.\u20082005;115(3):655\u2013661","DOI":"10.1542\/peds.2004-1238"},{"key":"2021120902492003300_R16","doi-asserted-by":"crossref","unstructured":"Walsh MC, Laptook A, Kazzi N, et al. A cluster randomized trial of benchmarking and multi-modal quality improvement to improve rates of survival free of bronchopulmonary dysplasia for infants with birth weights of less than 1250 grams. Pediatrics.\u20082007;119(5):876\u2013890","DOI":"10.1542\/peds.2006-2656"},{"key":"2021120902492003300_R17","unstructured":"Haynes RC, Murad F. Adrenocorticotropic hormone; adrenocortical steroids and their synthetic analogs; inhibitors of adrenocortical steroid biosynthesis. In: Gilman AG, Goodman LS, Rall TW, Murad F, eds. The Pharmacological Basis of Therapeutics. New York, NY: Macmillan Publishing Company; 1985:1475"},{"key":"2021120902492003300_R18","doi-asserted-by":"crossref","unstructured":"Kramer MS, Platt RW, Wen SW, et al. A new and improved population-based Canadian reference for birth weight for gestational age. Pediatrics.\u20082001;108(2). Available at: www.pediatrics.org\/cgi\/content\/full\/108\/2\/e35","DOI":"10.1542\/peds.108.2.e35"},{"key":"2021120902492003300_R19","doi-asserted-by":"crossref","unstructured":"Richardson DK, Phibbs CS, Gray JE, et al. Birth weight and illness severity: independent predictors of neonatal mortality. Pediatrics.\u20081993;91(5):969\u2013975","DOI":"10.1542\/peds.91.5.969"},{"key":"2021120902492003300_R20","doi-asserted-by":"crossref","unstructured":"Romagnoli C, Zecca E, Tortorolo L, Vento G, Tortorolo G. A scoring system to predict the evolution of respiratory distress syndrome into chronic lung disease in preterm infants. Intensive Care Med.\u20081998;24(5):476\u2013480","DOI":"10.1007\/s001340050599"},{"key":"2021120902492003300_R21","doi-asserted-by":"crossref","unstructured":"Walsh MC, Wilson-Costello D, Zadell A, Newman N, Fanaroff A. Safety, reliability and validity of a physiologic definition of bronchopulmonary dysplasia. J Perinatol.\u20082003;23(6):451\u2013456","DOI":"10.1038\/sj.jp.7210963"},{"key":"2021120902492003300_R22","doi-asserted-by":"crossref","unstructured":"Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhages: a study of infants with birth weights less than 1500 grams. J Pediatr.\u20081978;92(4):529\u2013534","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"2021120902492003300_R23","doi-asserted-by":"crossref","unstructured":"Quinn GE, Schaffer DB, Johnson L. A revised classification of retinopathy of prematurity. Am J Ophthalmol.\u20081982;94(6):744\u2013749","DOI":"10.1016\/0002-9394(82)90298-7"},{"key":"2021120902492003300_R24","doi-asserted-by":"crossref","unstructured":"International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol.\u20082005;123(7):991\u2013999","DOI":"10.1001\/archopht.123.7.991"},{"key":"2021120902492003300_R25","doi-asserted-by":"crossref","unstructured":"Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis; therapeutic decisions based on clinical staging. Ann Surg.\u20081978;187(1):1\u20137","DOI":"10.1097\/00000658-197801000-00001"},{"key":"2021120902492003300_R26","doi-asserted-by":"crossref","unstructured":"Amiel-Tison C, Stewart AL. Follow-up studies in the first five years of life: a pervasive assessment of neurologic function. Arch Dis Child.\u20081989;64(4):496\u2013502","DOI":"10.1136\/adc.64.4_Spec_No.496"},{"key":"2021120902492003300_R27","unstructured":"Bayley N. Bayley Scales of Infant Development. 2nd ed. San Antonio, TX: Psychological Corp; 1993"},{"key":"2021120902492003300_R28","doi-asserted-by":"crossref","unstructured":"Bax M. Terminology and classification of cerebral palsy. Dev Med Child Neurol.\u20081964;6:295\u2013297","DOI":"10.1111\/j.1469-8749.1964.tb10791.x"},{"key":"2021120902492003300_R29","doi-asserted-by":"crossref","unstructured":"Walsh MC, Yao Q, Horbar JD, Carpenter JH, Lee SK, Ohlsson A. Changes in the use of postnatal steroids for bronchopulmonary dysplasia in 3 large neonatal networks. Pediatrics.\u20082006;118(5). Available at: www.pediatrics.org\/cgi\/content\/full\/118\/5\/e1328","DOI":"10.1542\/peds.2006-0359"},{"key":"2021120902492003300_R30","doi-asserted-by":"crossref","unstructured":"Shinwell ES, Lerner-Geva L, Lusky A, Reichman B. Less postnatal steroids, more bronchopulmonary dysplasia: a population-based study in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed.\u20082007;92(1):F30\u201333","DOI":"10.1136\/adc.2006.094474"},{"key":"2021120902492003300_R31","doi-asserted-by":"crossref","unstructured":"Kumar P. Effect of decreased use of postnatal corticosteroids on morbidity in extremely low birthweight infants. Am J Perinatol.\u20082005;22(2):77\u201381","DOI":"10.1055\/s-2005-837274"},{"key":"2021120902492003300_R32","doi-asserted-by":"crossref","unstructured":"Truffert P, Empana JP, Breart G, et al. Treatment strategies for bronchopulmonary dysplasia with postnatal corticosteroids in Europe: the EURAIL survey. Acta Paediatr.\u20082003;92(8):948\u2013951","DOI":"10.1080\/08035250310002579"},{"key":"2021120902492003300_R33","doi-asserted-by":"crossref","unstructured":"O'Shea TM, Kothadia JM, Klinepeter KL, et al. Randomized placebo-controlled trial of a 42 day tapering course of dexamethasone to reduce the duration of ventilator dependency in very low birth weight infants: outcomes of study participants at 1-year adjusted age. Pediatrics.\u20081999;104(1 pt 1):15\u201321","DOI":"10.1542\/peds.104.1.15"},{"key":"2021120902492003300_R34","doi-asserted-by":"crossref","unstructured":"Gross SJ, Anbar RD, Mettelmann BB. Follow-up at 15 years of preterm infants from a controlled trial of moderately early dexamethasone for the prevention of chronic lung disease. Pediatrics.\u20082005;115(3):681\u2013687","DOI":"10.1542\/peds.2004-0956"},{"key":"2021120902492003300_R35","doi-asserted-by":"crossref","unstructured":"Kobaly K, Schluchter M, Friedman H, et al. Outcomes of extremely low birth weight (&lt;1 kg) and extremely low gestational age (&lt;28 week) infants with bronchopulmonary dysplasia: effects of practice change in 2000\u20132003. Pediatrics.\u20082008;121(1):73\u201381","DOI":"10.1542\/peds.2007-1444"},{"key":"2021120902492003300_R36","doi-asserted-by":"crossref","unstructured":"Slotkin TA, Keider ML, Tate CA, Seidler FJ. Critical prenatal and postnatal periods for persistent effects of dexamethasone on serotonergic and dopaminergic systems. Neuropsychopharmacology.\u20082006;31(5):904\u2013911","DOI":"10.1038\/sj.npp.1300892"},{"key":"2021120902492003300_R37","doi-asserted-by":"crossref","unstructured":"McGowan JE, Sysyn G, Peterson KH, et al. Effect of dexamethasone treatment on maturational changes in the NMDA receptor in sheep brain. J Neurosci.\u20082000;20(19):7424\u20137429","DOI":"10.1523\/JNEUROSCI.20-19-07424.2000"},{"key":"2021120902492003300_R38","doi-asserted-by":"crossref","unstructured":"Kreider ML, Tate CA, Cousins MM, et al. Lasting effects of developmental dexamethasone treatment on neural cell number and size, synaptic activity, and cell signaling: critical periods of vulnerability, dose-effect relationships, regional targets and sex selectivity. Neuropsychopharmacology.\u20082006;31(1):12\u201335","DOI":"10.1038\/sj.npp.1300783"},{"key":"2021120902492003300_R39","doi-asserted-by":"crossref","unstructured":"Powell K, Kerkering KW, Barker G, Rozycki HJ. Dexamethasone dosing, mechanical ventilation and the risk of cerebral palsy. J Maternal Fetal Neonatal Med.\u20082006;19(1):43\u201348","DOI":"10.1080\/14767050500363519"},{"key":"2021120902492003300_R40","doi-asserted-by":"crossref","unstructured":"Arias-Camison JM, Lau J, Cole CH, Frantz ID. Meta-analysis of dexamethasone therapy started in the first 15 days of life for the prevention of chronic lung disease in premature infants. Pediatr Pulmonol.\u20081999;28(3):167\u2013174","DOI":"10.1002\/(SICI)1099-0496(199909)28:3<167::AID-PPUL2>3.0.CO;2-Y"},{"key":"2021120902492003300_R41","unstructured":"Shah V, Ohlsson A. Postnatal dexamethasone in the prevention of chronic lung disease. In: David TJ, ed. Recent Advances in Pediatrics 19. London, England: Churchill Livingstone; 2001:77\u201396"},{"key":"2021120902492003300_R42","doi-asserted-by":"crossref","unstructured":"Yeh TF, Lin YL, Lin HC, et al. Outcomes at school age after postnatal dexamethasone therapy for lung disease of prematurity. N Engl J Med.\u20082004;350(13):1304\u20131313","DOI":"10.1056\/NEJMoa032089"},{"key":"2021120902492003300_R43","doi-asserted-by":"crossref","unstructured":"Vermont Oxford Network Steroid Study Group. Early postnatal dexamethasone therapy for the prevention of chronic lung disease. Pediatrics.\u20082001;108(3):741\u2013748","DOI":"10.1542\/peds.108.3.741"},{"key":"2021120902492003300_R44","doi-asserted-by":"crossref","unstructured":"Halliday HL. Postnatal dexamethasone: what is the real cost-benefit ratio?Acta Paediatr.\u20082003;92(8):888\u2013889","DOI":"10.1111\/j.1651-2227.2003.tb00619.x"},{"key":"2021120902492003300_R45","unstructured":"Hofkosh D, Brozanski BS, Edwards MD, et al. One year outcome of infants treated with pulse dexamethasone for prevention of BPD [abstract]. Pediatr Res.\u20081995;37:259"},{"key":"2021120902492003300_R46","doi-asserted-by":"crossref","unstructured":"McEwen BS. The brain is an important target of adrenal steroid actions: a comparison of synthetic and natural steroids. Ann N Y Acad Sci.\u20081997;823:201\u2013213","DOI":"10.1111\/j.1749-6632.1997.tb48392.x"},{"key":"2021120902492003300_R47","doi-asserted-by":"crossref","unstructured":"De Kloet RE, Vreugdenhill E, Oitzl MS, Joel M. Brain corticosteroid receptor balance in health and disease. Endocr Rev.\u20081998;19(3):269\u2013301","DOI":"10.1210\/edrv.19.3.0331"},{"key":"2021120902492003300_R48","doi-asserted-by":"crossref","unstructured":"Ferguson SA, Paule MG, Holson RR. Neonatal dexamethasone on day 7 in rats causes behavioral alterations reflective of hippocampal, but not cerebellar deficits. Neurotoxicol.Teratol.\u20082001;23(1):57\u201369","DOI":"10.1016\/S0892-0362(00)00115-X"},{"key":"2021120902492003300_R49","doi-asserted-by":"crossref","unstructured":"Hassan AHS, von Rosenstiel P, Patchev VK, Holsboer F, Almeida OFX. Exacerbation of apoptosis in the dentate gyrus of the aged rat by dexamethasone and the protective role of corticosterone. Exp Neurol.\u20081996;140(1):43\u201352","DOI":"10.1006\/exnr.1996.0113"},{"key":"2021120902492003300_R50","doi-asserted-by":"crossref","unstructured":"Lodygensky GA, Rademaker K, Zimine S, et al. Structural and functional brain development after hydrocortisone treatment for neonatal chronic lung disease. Pediatrics.\u20082005;116(1):1\u20137","DOI":"10.1542\/peds.2004-1275"},{"key":"2021120902492003300_R51","doi-asserted-by":"crossref","unstructured":"Van der Heide-Jalving M, Kamphuis PJGH, van der Laan MJ, et al. Short and long-term effects of neonatal glucocorticoid therapy: is hydrocortisone an alternative to dexamethasone?Acta Paediatr.\u20082003;92(7):827\u2013835","DOI":"10.1111\/j.1651-2227.2003.tb02541.x"},{"key":"2021120902492003300_R52","doi-asserted-by":"crossref","unstructured":"Watterberg KL, Shaffer ML, Mishefske MJ, et al. Growth and neurodevelopmental outcomes after early low-dose hydrocortisone treatment in extremely low birth weight infants. Pediatrics.\u20082007;120(1):40\u201348","DOI":"10.1542\/peds.2006-3158"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/123\/3\/e430\/1067394\/zpe0030900e430.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/123\/3\/e430\/1067394\/zpe0030900e430.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T23:08:40Z","timestamp":1684883320000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/123\/3\/e430\/71706\/Impact-of-Postnatal-Corticosteroid-Use-on"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,3,1]]},"references-count":52,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2009,3,1]]},"published-print":{"date-parts":[[2009,3,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2008-1928","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,3,1]]}}}