Effects of prophylactic hydrocortisone in a tertiary Canadian NICU

Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Recent evidence suggests that the use of physiological doses of hydrocortisone for the prevention of death or BPD may outweigh the potential risks.1–3 Starting in 2019, all infants born <28 weeks gestational age (GA) in our tertiary care NICU received physiologic doses of hydrocortisone, starting within 24 hours post-birth. Our objective was to determine the effect of prophylactic hydrocortisone on the incidence of survival without moderate or severe BPD; secondary objectives assessed duration of respiratory support and safety outcomes.

We performed a single-centre retrospective cohort study of infants born <28 weeks GA during two epochs, before (16 months) and after (19 months) the implementation of prophylactic hydrocortisone. The primary objective was evaluated …

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