© 1999 by Oxford University Press
Brief report. Early dexamethasone treatment in preterm infants treated with surfactant: a double blind controlled trial
A Division of Neonatology, Department of Pediatrics, B King Fahd University Hospital, Alkhobar, Saudi Arabia Z Corresponding author Tel: +966 3 844 1592
The objective of the study was to test the hypothesis that early postnatal dexamethasone administration (days 1-5) in preterm infants with respiratory distress syndrome would improve acute respiratory status and therefore decrease long-term neonatal morbidity. This was a prospective, blind randomized controlled trial. Eligible neonates were preterm infants with birthweight 
1500 g who developed respiratory distress syndrome requiring mechanical ventilation and surfactant. A 5-day course of dexamethasone or placebo was initiated within the first 6h after birth. The starting dose of dexamethasone was 0.5 mg/kg/day and it was tapered progressively. Results were analysed with t-test 
2, Wilcoxon test, and ANOVA. Twenty-nine infants (n=15 of early dexamethasone and n=14 of placebo group) fulfilled the inclusion criteria. The dexamethasone group exhibited a significant improvement in arterial to alveolar oxygen ratio only between postnatal days 2 and 5 (p=0.02). This initial improvement was not associated with long-term benefits. Infants who received dexamethasone had increased systolic blood pressure (p=0.0001), diastolic blood pressure (p=0.001), blood sugar (p=0.02, serum urea (p=0.03), and creatinine level (p=0.02). All these side-effects were resolved by postnatal day 7. We concluded that a 5-day course of early postnatal dexamethasone was associated with only a transient improvement in oxygenation with no long-term benefits. Side-effects were more common in the dexamethasone group.