OBJECTIVES Corticosteroids are used to prevent or treat lung disease of prematurity. While neurological side effects have been reported, detailed effects on cerebellar growth are unknown. This study aimed to compare cerebellar growth in premature infants who received dexamethasone or hydrocortisone to premature infants who did not receive postnatal corticosteroids. STUDY DESIGN Retrospective case-control study in infants born at a gestational age of <29 weeks and admitted to two level 3 neonatal intensive care units. Exclusion criteria were severe congenital anomalies and cerebellar or severe supratentorial lesions. Infants were treated with dexamethasone (unit 1) or hydrocortisone (unit 2) for chronic lung disease. Controls (unit 1) did not receive postnatal corticosteroids. Sequential head circumference (HC) and ultrasound measurements of transcerebellar diameter (TCD), biparietal diameter (BPD), and corpus callosum-fastigium length (CCFL) were performed until 40 weeks' postmenstrual age (PMA). Growth was assessed using linear mixed models correcting for PMA at measurement, sex, HC z-score at birth, and a propensity score indicating illness severity. Group differences before treatment were assessed using linear regression. RESULTS 346 infants were included (68 dexamethasone, 37 hydrocortisone, 241 controls). Before starting corticosteroids, TCD, BPD, and HC measurements did not differ between patients and controls at a comparable PMA. After starting treatment, both types of corticosteroid had a negative association with TCD growth. BPD, CCFL, and HC growth were not negatively affected. CONCLUSION Administration of dexamethasone and hydrocortisone are both associated with impaired cerebellar growth in premature infants without evident negative associations with cerebral growth.

中文翻译：

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地塞米松和氢化可的松与早产儿小脑生长的关系。

目的 皮质类固醇用于预防或治疗早产儿肺部疾病。虽然已经报道了神经系统副作用，但对小脑生长的详细影响尚不清楚。本研究旨在比较接受地塞米松或氢化可的松的早产儿与未接受产后皮质类固醇的早产儿的小脑生长情况。研究设计 对胎龄 <29 周出生并入住两个 3 级新生儿重症监护病房的婴儿进行回顾性病例对照研究。排除标准是严重的先天性异常和小脑或严重的幕上病变。婴儿接受地塞米松（第 1 单元）或氢化可的松（第 2 单元）治疗慢性肺病。对照组（单元 1）未接受产后皮质类固醇治疗。连续进行头围 (HC) 和超声测量小脑直径 (TCD)、双顶直径 (BPD) 和胼胝体-峰顶长度 (CCFL)，直至经后年龄 (PMA) 40 周。使用线性混合模型评估生长情况，校正测量时的 PMA、性别、出生时 HC z 分数以及指示疾病严重程度的倾向分数。使用线性回归评估治疗前的组间差异。结果 纳入 346 名婴儿（68 名使用地塞米松，37 名使用氢化可的松，241 名对照）。在开始皮质类固醇治疗之前，在可比较的 PMA 下，患者和对照组之间的 TCD、BPD 和 HC 测量值没有差异。开始治疗后，两种类型的皮质类固醇均与 TCD 生长呈负相关。BPD、CCFL 和 HC 的生长没有受到负面影响。结论 地塞米松和氢化可的松的使用均与早产儿小脑生长受损有关，但与脑生长没有明显的负相关。