Decreasing Incidence of Chronic Lung Disease Despite the Gradual Reduction of Postnatal Dexamethasone Use in Very Low Birth Weight Infants

Dexamethasone has been widely used in very low birth weight infants (VLBWI) weighing less than 1,500 g at birth for the prevention or treatment of chronic lung disease (CLD). Recently, however the use of dexamethasone is being reduced, as its association with abnormal neurodevelopmental outcome is known. On the other hand, there have been persistent concerns about the increased risk of CLD according to the reduction of postnatal dexamethasone use. Hence, we did a retrospective cohort study to delineate the change in the incidence of CLD according to the reduction of dexamethasone use in VLBWI. The medical records of 559 VLBWI admitted to neonatal intensive care unit at Samsung Medical Center between November 1994 and December 2002 were reviewed with a focus on the use of postnatal dexamethasone and the incidence of CLD. The use of postnatal dexamethasone has significantly decreased over the study period. Especially, the use of high-dose regimen has markedly decreased. The day when postnatal dexamethasone therapy was begun has also been significantly delayed. The incidence of CLD has significantly decreased over the same period. In conclusion, the incidence of CLD has not increased despite the decreased use of postnatal dexamethasone.