Distribution of measurements and course of body weight SD-scores in individual male children in each study group from birth to 48 months of age.

<p>Distribution of measurements and course of body weight SD-scores in individual male children in each study group from birth to 48 months of age.</p

Growth velocity for weight separate for boys in DEX (blue line), HC (red line) and untreated infants (black line).

<p>Note that age is on a logarithmic scale and reflects the midpoint of successive measurements, centered at one month of age.</p

Maximal (peak) growth velocity of infant weight and size and age at achievement.

<p>Maximal (peak) growth velocity of infant weight and size and age at achievement.</p

Neonatal corticosteroid therapy affects growth patterns in early infancy

<div><p>Objective</p><p>Although postnatal corticosteroid (CS) therapy has well established beneficial effects on pulmonary function, it may also result in growth restriction during treatment. The course of early childhood growth is believed to predict cardiovascular and metabolic diseases in adulthood. Therefore, we determined the effects of postnatal dexamethasone (DEX) or hydrocortisone (HC) treatment on patterns of postnatal growth until approximately four years of age.</p><p>Study design</p><p>In an observational cohort study of children born prematurely (<32 weeks of gestation), we compared growth patterns for body weight, height, and head circumference from birth to age four years, of children who received DEX (boys: N = 30, girls: N = 14), HC (boys: N = 33, girls: N = 28) to a reference group that had not received postnatal CSs (boys: N = 52, girls: N = 53) using linear mixed-effects modeling.</p><p>Results</p><p>Growth velocity curves of CS-treated neonates showed a shift to the right, representing a delay in time. They had decreased absolute growth velocities during and shortly after treatment, followed by an increase in growth velocity thereafter. A shift to the right was also seen for the age at which maximal growth velocity of weight/height was reached in boys and girls. Fractional growth rates of weight, height, and head circumference were generally reduced in the CS-treated groups during the first two months of age, with catch-up growth in the following months. In DEX-treated infants these changes were more pronounced than in HC-treated infants.</p><p>Conclusion</p><p>These data suggest that postnatal growth patterns of preterm born infants are affected by CS-treatment, more by DEX than by HC. Effects were observed mainly on growth velocities. This observation may have impact on health in later life for those individuals treated with CSs in the neonatal period. A definitive conclusion would require a randomized trial of these therapies.</p></div

Effect of antenatal dexamethasone treatment on the volume (A, B) and total number of neurons (C, D) of the hippocampus.

<p>Data are presented as mean ± SD. Panel A and C show a significant decrease in volume of the CA at P5 and P10 and in total number of neurons in the CA area at E18 until P10 and an increase of number of neurons in the CA of the dex-treated group at adulthood. Panel B shows an increase in volume of the DG of the dex-treated group at P10. Panel D shows a significant increase in total number of neurons in the DG of the dex-treated group at P10 and P20. Sal: saline-treatment (n = 8), dex: dexamethasone-treatment (n = 8). * p<0.05 (Two-Way ANOVA+Bonferroni).</p

Effect of antenatal dexamethasone treatment on the total number of proliferative cells in the subgranular zone of the DG.

<p>Data are presented as mean ± SD. At E18 and P0, the number of proliferative cells is decreased in the dex-treated group, while an increase is observed at P5 and P10. At the adult stage the number of proliferative cells are decreased in the dex-treated group. Sal: saline-treatment (n = 8), dex: dexamethasone-treatment (n = 8), * p<0.05 (Two-Way ANOVA+Bonferroni).</p

Effect of antenatal dexamethasone treatment on the total number of apoptotic cells in the pyramidal cell layer in the CA (A) and in the granule cell layer of the DG (B).

<p>Data are presented as mean ± SD. Apoptosis is significantly increased in the dex-treated group in both the CA area (E16, E18 and P0) and the DG (E18 and P0). Sal: saline-treatment (n = 8), dex: dexamethasone-treatment (n = 8), * p<0.05 (Two-Way ANOVA+Bonferroni).</p

Neonatal corticosteroid therapy affects growth patterns in early infancy - Fig 2

<p>Growth in weight of males (a) and females (b), in height of males (c) and females (d) and in head circumference of males (e) and females (f), ages 0 to 4 in DEX (blue line), HC (red line) and untreated (black line) infants using SD-scores.</p

Summary of the effects of antenatal dex treatment on proliferation and apoptosis in the DG during hippocampal development.

<p>The results of the dex treated groups are presented as percentage of the control (100%).</p

Density scores according to subgroups of patients characteristics.

<p>Numbers represent the median scores, assigned for density of large, small and neurons irrespective of size (see text for details). Between square brackets: p25–p75 range.</p><p>Differences are tested with the Mann-Whitney U test.</p