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TABLE 3

RCTs of Early Hydrocortisone to Prevent BPD

Study, No. of CentersnPopulation: Mechanically Ventilated InfantsHydrocortisone Dosing RegimenRate of Survival Without BPDa HC vs Placebo, %
Watterberg et al,38  2 centers 40 500–999 g BW; <48 h postnatal age 0.5 mg/kg every 12 h for 9 d 60 vs 35(P = .04) 
   0.25 mg/kg every 12 h for 3 d  
Watterberg et al,39  9 centers 360b 500–999 g BW; <48 h postnatal age 0.5 mg/kg every 12 h for 12 d 35 vs 34(aORc: 1.20 [95% CI: 0.72–1.99]) 
   0.25 mg/kg every 12 h for 3 d  
Peltoniemi et al,40  3 centers 51b 501–1250 g BW; <36 h postnatal age 2.0 mg/kg per d tapered to 0.75 mg/kg per d over 10 d 64 vs 46(OR: 1.48 [95% CI: 0.49–4.48]) 
Bonsante et al,41  2 centers 50b 500–1249 g BW; <48 h postnatal age 0.5 mg/kg every 12 h for 9 d; 0.25 mg/kg every 12 h for 3 d 64 vs 32(P < .05) 
Total 601 — — — 
Study, No. of CentersnPopulation: Mechanically Ventilated InfantsHydrocortisone Dosing RegimenRate of Survival Without BPDa HC vs Placebo, %
Watterberg et al,38  2 centers 40 500–999 g BW; <48 h postnatal age 0.5 mg/kg every 12 h for 9 d 60 vs 35(P = .04) 
   0.25 mg/kg every 12 h for 3 d  
Watterberg et al,39  9 centers 360b 500–999 g BW; <48 h postnatal age 0.5 mg/kg every 12 h for 12 d 35 vs 34(aORc: 1.20 [95% CI: 0.72–1.99]) 
   0.25 mg/kg every 12 h for 3 d  
Peltoniemi et al,40  3 centers 51b 501–1250 g BW; <36 h postnatal age 2.0 mg/kg per d tapered to 0.75 mg/kg per d over 10 d 64 vs 46(OR: 1.48 [95% CI: 0.49–4.48]) 
Bonsante et al,41  2 centers 50b 500–1249 g BW; <48 h postnatal age 0.5 mg/kg every 12 h for 9 d; 0.25 mg/kg every 12 h for 3 d 64 vs 32(P < .05) 
Total 601 — — — 

BW indicates birth weight; aOR, adjusted odds ratio; OR, odds ratio; CI, confidence interval.

a

BPD was defined as receiving supplemental oxygen at 36 weeks' postmenstrual age.

b

Study enrollment was terminated early because of concern for spontaneous gastrointestinal perforation.

c

Adjusted for center, birth weight, risk factors (gender, “outborn” [infants who were born at an outlying institution and transported into the study center], white race, vaginal delivery, no prenatal steroids, hydrocortisone, and/or vasopressor support at study entry).

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