Postnatal steroids in preterm infants associated with severity of retinopathy of prematurity

Cumulative dose and duration of postnatal steroid use are independently associated with the severity of retinopathy of prematurity (ROP) and the development of peripheral avascular retina (PAR) in preterm infants, according to a study.

 Of the 1695 infants born at ≤32 weeks gestation and/or with a birth weight ≤1500 g included in this study, 67% received postnatal steroid treatment. The infants had an average birth weight of 1142 ± 396 g and gestational age of 28.6 ± 2.7 weeks. The mean cumulative dose of steroids prescribed was 28.5 ± 74.3 mg/kg, and the average duration of treatment was 8.9 ± 35.1 days.

After accounting for major demographic differences, the researchers found a significant association between higher cumulative doses and longer durations of steroid therapy and an increased incidence of severe ROP and PAR (P < 0.001). For each additional day of steroid treatment, there was a 3.2% increase in the hazard of developing the severe form of ROP (95% CI: 1.022-1.043). Moreover, the time required to achieve full retinal vascularization was delayed by 5.7% (95% CI: 1.04-1.08) for each day of steroid treatment (P < 0.001).

Reference
Shekhawat PS, Ali MAM, Kannekanti N, et al. Impact of postnatal steroids on peripheral avascular retina and severity of retinopathy of prematurity. Pediatr Res. 2023;doi: 10.1038/s41390-023-02673-4. Epub ahead of print. PMID: 37291231.