
A retrospective cohort study compared the neurodevelopmental outcomes of extremely premature infants treated with alternatives to dexamethasone—betamethasone and hydrocortisone hemisuccinate. Among 192 infants born before 29 weeks of gestational age, 30.7% received late postnatal steroids. Results indicated that while suboptimal neurodevelopment affected 62.7% of postnatal steroid-treated infants compared to 38.1% untreated, multivariable analysis revealed no independent risk from betamethasone or hydrocortisone hemisuccinate. Severe neonatal morbidity and male gender were associated with suboptimal neurodevelopment at 24 months. The study suggests that these alternatives do not independently contribute to adverse outcomes in extremely premature infants.
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