Prescribing practices of inhaled corticosteroids for premature infants in the neonatal intensive care unit

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2024年1月31日

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Monica Tang,
Anna Ibrahim,
Christopher Laughon,
Kaila Moore,
Angibel Tejada,
Dean Tran,
Ryan Kilpatrick,
Rachel G. Greenberg,
Christoph P. Hornik,
Kanecia Zimmerman,
Matthew M. Laughon,
Reese H. Clark,
Jason E. Lang

摘要

Objective

Despite limited safety and efficacy data, inhaled corticosteroids (ICS) are prescribed to premature infants in the neonatal intensive care unit (NICU). We examined contemporary use and risk factors for ICS use in the NICU.

Study design

Infants <33 weeks gestational age and <1500 gm birth weight discharged from Pediatrix Medical Group NICUs between 2010 and 2020 were included. We evaluated the association between ICS prescription and clinical characteristics using univariable and multivariable logistic regression.

Results

Of 74,123 infants from 308 NICUs, 9253 (12.5%) were prescribed ICS: budesonide, fluticasone, or beclomethasone. Diagnosis of bronchopulmonary dysplasia (BPD), earlier gestational age, male sex, longer mechanical ventilation, oxygen support, and systemic steroids were independent risk factors for ICS prescription.

Conclusions

Use of ICS is common in many NICUs and is associated with a diagnosis of BPD and healthcare utilization. Prospective trials are needed to establish the safety, efficacy, and optimal indication in this vulnerable population.