There is concern that corticosteroids, particularly dexamethasone administered to preterm infants starting in the first 4 days of life, cause long-term neurodevelopmental sequelae.1–3 The typical relative risk for cerebral palsy is 2.32 with a 95% confidence interval (CI) of 1.48 to 3.65 and a risk difference of 0.12 (95% CI: 0.06–0.18), which translates into a number needed to treat (or harm) of 8.3 (95% CI: 5.5–16.7).3 Barrington has noted that because of cross-over treatment of control infants the adverse effects of postnatal steroids are likely to be even greater.4 He reported a relative risk of 2.86 (95% CI: 1.95–4.19) for cerebral palsy using studies with <30% cross-over.4
Recently the Committee on Fetus and Newborn of the American Academy of Pediatrics and the Fetus and Newborn Committee of the Canadian Paediatric Society reviewed the evidence and made 5 recommendations:5
Similar recommendations had previously been...
