Functional outcome at school age of preterm-born children treated with high-dose dexamethasone

Background: Postnatal dexamethasone (DXM) treatment is associated with adverse motor outcome. It is largely unknown as to what extent functional outcome at school age is affected. Aims: Our first aim was to determine motor, cognitive, and behavioural outcome at school age of preterm-born children treated with high-dose DXM for pulmonary problems. Our second aim was to identify DXM-related risk factors for adverse outcome. Study design: In this cohort study, we included 53 very preterm-born children treated with DXM (starting dose 0.5 mg/kg/d) after the first week of life. At the median age of 9 years, we performed a detailed neuropsychological assessment. Results: Compared to the norm population, DXM-treated children scored worse on the Movement-ABC (abnormal fine motor, ball skills and balance: 59%, 47% and 30%, respectively). They more often had total (36%), verbal (32%) and performance IQs (55%) below 85 (P <.001, P =.002, P <.001, respectively). On each of the remaining measures, DXM-treated children scored worse than the norm population, except for verbal long-term memory and verbal recognition memory. DXM-related risk factors were associated with poorer performance. Conclusions: At school age, multiple domains of functional outcome were affected in DXM-treated children. Risk factors related to the use of DXM should be considered as serious potentiaters of adverse outcome in children treated with high-dose DXM. (C) 2014 Elsevier Ireland Ltd. All rights reserved.