The Effect of Hydrocortisone Treatment After Day Fourteen of Life on Preventing Bronchopulmonary Dysplasia in Preterm Infants

Background: This study aimed to evaluate whether administering low-dose hydrocortisone after the first fourteen days of life affects the incidence of bronchopulmonary dysplasia (BPD), mortality, and other short-term complications in mechanically ventilated preterm infants. Methods: A randomized clinical trial was conducted between 2019 and 2022 in the NICUs of Shariati and Valiasr hospitals in Tehran. Infants received either hydrocortisone or placebo for 10 days and were followed until a corrected gestational age of 36 weeks. Baseline characteristics, primary outcomes, and secondary outcomes were recorded for all participants. Results: The mean gestational age of infants in this study was 28.2 ± 1.79 weeks. The cohort included 45 male infants (64.3%) and 25 female infants (35.7%). Mortality rates and the need for supportive oxygen treatment were significantly different between the two groups (P < 0.05). The rate of hypertrophic myocarditis also differed significantly (P < 0.05). Conclusion: In summary, systemic corticosteroid use led to reductions in mortality and BPD by corrected age of 36 weeks. Although there are differences between dexamethasone and hydrocortisone, hydrocortisone decreased mortality but did not significantly reduce BPD incidence. Moreover, late systemic hydrocortisone treatment significantly shortened the duration of mechanical ventilation in infants.