{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:26:26Z","timestamp":1790375186595,"version":"4.1.0"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,8,1]]},"abstract":"<jats:p>OBJECTIVE: To assess dexamethasone (DEX) and hydrocortisone (HC) use in premature infants over time and the association of steroid use with the incidence of bronchopulmonary dysplasia (BPD) at 36 weeks' postmenstrual age.<\/jats:p>\n               <jats:p>METHODS: We analyzed data from the Pediatrix database for neonates of 23 to 32 weeks' gestation managed during 1997\u20132006 (N = 77520). We compared the use of DEX, HC and BPD (defined by oxygen use at 36 weeks' postmenstrual age) according to year and estimated gestational age. Mantel-Haenszel \u03c72 was used to compare the trends in steroid use and BPD rates according to year.<\/jats:p>\n               <jats:p>RESULTS: There were no differences by year in the proportion of births at each gestation or in early or late neonatal death. DEX use decreased from a peak of 25.0% in 1998 to 6.8% in 2006, but HC use increased from 1.1% in 1997 to a peak of 6.5% in 2006. The median age at initiation of DEX use increased &amp;gt;2 weeks from 1997 to 2006. BPD rates increased from 19% in 1997 to 25% by 2006. Rates for severe BPD (defined by positive pressure support) also increased significantly over time. Between 23 and 28 weeks, there was a significant increase in BPD rates associated with the decrease in DEX over time.<\/jats:p>\n               <jats:p>CONCLUSIONS: Steroid use and preference have changed significantly over the past decade. Decreased use of DEX was associated with increased rates of BPD, any or severe, among very preterm infants. Well-designed, randomized, noncrossover trials with long-term outcome analysis of high-risk infants are needed.<\/jats:p>","DOI":"10.1542\/peds.2008-2793","type":"journal-article","created":{"date-parts":[[2009,7,21]],"date-time":"2009-07-21T00:34:48Z","timestamp":1248136488000},"page":"673-679","source":"Crossref","is-referenced-by-count":84,"title":["Time-Related Changes in Steroid Use and Bronchopulmonary Dysplasia in Preterm Infants"],"prefix":"10.1542","volume":"124","author":[{"given":"Bradley A.","family":"Yoder","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reese H.","family":"Clark","sequence":"additional","affiliation":[{"name":"Pediatrix Medical Group, Sunrise, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2009,8,1]]},"reference":[{"key":"2021120905294975400_R1","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":"2021120905294975400_R2","doi-asserted-by":"crossref","unstructured":"Halliday H, Ehrenkranz R, Doyle L. Early postnatal (&lt;96 hours) corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev.\u20082003;(1):CD001146","DOI":"10.1002\/14651858.CD001146"},{"key":"2021120905294975400_R3","doi-asserted-by":"crossref","unstructured":"Halliday H, Ehrenkranz R, Doyle L. Delayed (&gt; 3 weeks) postnatal corticosteroids for chronic lung disease in preterm infants. Cochrane Database Syst Rev.\u20082003;(1):CD001145","DOI":"10.1002\/14651858.CD001145"},{"key":"2021120905294975400_R4","doi-asserted-by":"crossref","unstructured":"Halliday H, Ehrenkranz R, Doyle L. Moderately early (7\u201314 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev.\u20082003;(1):CD001144","DOI":"10.1002\/14651858.CD001144"},{"key":"2021120905294975400_R5","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Fetus and Newborn. 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":"2021120905294975400_R6","doi-asserted-by":"crossref","unstructured":"Canadian Paediatric Society. Postnatal corticosteroids to treat or prevent chronic lung disease in preterm infants. Paediatr Child Health.\u20082002;7(1):20\u201328","DOI":"10.1093\/pch\/7.1.20"},{"key":"2021120905294975400_R7","doi-asserted-by":"crossref","unstructured":"Finer NN, Powers RJ, Ou CS, et al. Prospective evaluation of postnatal steroid administration: a 1-year experience from the California Perinatal Quality Care Collaborative. Pediatrics.\u20082006;117(3):704\u2013713","DOI":"10.1542\/peds.2005-0796"},{"key":"2021120905294975400_R8","doi-asserted-by":"crossref","unstructured":"Shinwell E, 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\u2013F33","DOI":"10.1136\/adc.2006.094474"},{"key":"2021120905294975400_R9","doi-asserted-by":"crossref","unstructured":"Walsh MC, Yao Q, Gettner P, et al. Impact of a physiologic definition on bronchopulmonary dysplasia rates. Pediatrics.\u20082004;114(5):1305\u2013s1311","DOI":"10.1542\/peds.2004-0204"},{"key":"2021120905294975400_R10","doi-asserted-by":"crossref","unstructured":"Halliday H. 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