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). Barrington has noted that because of cross-over treatment of control infants the adverse effects of postnatal steroids are likely to be even greater. He reported a relative risk of 2.86 (95% CI: 1.95–4.19) for cerebral palsy using studies with <30% cross-over.

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:

Similar recommendations had previously been...

You do not currently have access to this content.