Drug for preemies linked to problems

Treating premature infants with a common steroid can prevent chronic lung disease, but possibly at a cost, a new study finds. Scientists in Taiwan randomly assigned 262 premature infants, all on respirators, to receive periodic infusions of either dexamethasone or saline solutions for 4 weeks. Many premature infants need respirators, but the force of the machines can damage preemie lungs.

Babies treated with dexamethasone had half as much chronic lung disease after the first month of life as did infants getting the saline. Roughly two-fifths of the children in each group died before reaching school age.

Follow-up of 146 of the survivors at an average age of 8 years showed that those who had received the steroid tended to be shorter and had smaller head circumferences than did children who had received the inert treatment. Dexamethasone-treated children also had poorer motor coordination, lower IQs, and more disabilities, the researchers report in the March 25 New England Journal of Medicine.

Study coauthor Tsu F. Yeh of China Medical University in Taichung, Taiwan, says that doctors treating premature infants with dexamethasone should consider substituting hydrocortisone, a less potent steroid.