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Background <p>To assess whether administering hydrocortisone in the perinatal period is associated with subsequent adverse cardiovascular outcomes.</p> Methods <p>The children/adolescents enrolled in the PREMILOC trial underwent resting blood pressure (BP) measurement, tonometry evaluation (pulse wave velocity (PWV), aortic systolic BP), continuous BP and ECG measurements (supine and standing), and ambulatory BP monitoring. Heart rate variability (HRV) indices, baroreflex sensitivity (BRS), and orthostatic systolic BP (SBP) response were calculated.</p> Results <p>Fifty-two subjects (median [25th; 75th percentile] birth weight: 892 g [750; 982]; gestational age: 26<sup>+3</sup> [25<sup>+1</sup>; 27<sup>+4</sup>]; age at assessment: 11.7 years [10.5; 12.7]; z-score of body mass index: 0.23 [−0.65; 1.27]; 27 girls) who received hydrocortisone (<i>n</i> = 28) or placebo (<i>n</i> = 24) were enrolled. The PWV was not different (hydrocortisone: 4.84 m/s [4.40; 5.48] vs. placebo: 5.00 m/s [4.48; 5.34], <i>p</i> = 0.969), and similar results were observed for HRV and BP measurements. Overweight/obese children (<i>n</i> = 17) vs. other children (<i>n</i> = 35) were characterized by higher office SBP, lower supine descending BRS, and higher orthostatic SBP response.</p> Conclusion <p>Early hydrocortisone administration after extremely preterm birth in a randomized trial is not associated with detrimental cardiovascular indices in children/adolescents, while overweight/obesity is already associated with cardiovascular morbidity.</p> <p>The study has been registered, ClinicalTrials.gov ID NCT05451264: <a href="https://clinicaltrials.gov/study/NCT05451264?cond=NCT05451264&amp;rank=1">https://clinicaltrials.gov/study/NCT05451264?cond=NCT05451264&amp;rank=1</a>.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>A meta-analysis on the effects of early postnatal administration of corticosteroids concluded that the hypertensive risk was increased in infants, but that long-term studies should be carried out.</p> </ItemContent> <ItemContent> <p>We show that early hydrocortisone administration after extremely preterm birth in a randomized trial is not associated with detrimental cardiovascular indices in children/adolescents, at least in one center of the trial</p> </ItemContent> <ItemContent> <p>Thus, our study suggests that early markers of the risk of hypertension are not altered by hydrocortisone.</p> </ItemContent> </UnorderedList></p>

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Hydrocortisone administration in preterm infants is not associated with adverse cardiovascular outcomes in childhood

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月9日

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  • Cherine Benzouid,
  • Plamen Bokov,
  • Pierre Coste,
  • Sehomi Azonaha,
  • Kadiatou Diallo,
  • Sophie Guilmin-Crépon,
  • Olivier Baud,
  • Valérie Biran,
  • Christophe Delclaux

摘要

Background

To assess whether administering hydrocortisone in the perinatal period is associated with subsequent adverse cardiovascular outcomes.

Methods

The children/adolescents enrolled in the PREMILOC trial underwent resting blood pressure (BP) measurement, tonometry evaluation (pulse wave velocity (PWV), aortic systolic BP), continuous BP and ECG measurements (supine and standing), and ambulatory BP monitoring. Heart rate variability (HRV) indices, baroreflex sensitivity (BRS), and orthostatic systolic BP (SBP) response were calculated.

Results

Fifty-two subjects (median [25th; 75th percentile] birth weight: 892 g [750; 982]; gestational age: 26+3 [25+1; 27+4]; age at assessment: 11.7 years [10.5; 12.7]; z-score of body mass index: 0.23 [−0.65; 1.27]; 27 girls) who received hydrocortisone (n = 28) or placebo (n = 24) were enrolled. The PWV was not different (hydrocortisone: 4.84 m/s [4.40; 5.48] vs. placebo: 5.00 m/s [4.48; 5.34], p = 0.969), and similar results were observed for HRV and BP measurements. Overweight/obese children (n = 17) vs. other children (n = 35) were characterized by higher office SBP, lower supine descending BRS, and higher orthostatic SBP response.

Conclusion

Early hydrocortisone administration after extremely preterm birth in a randomized trial is not associated with detrimental cardiovascular indices in children/adolescents, while overweight/obesity is already associated with cardiovascular morbidity.

The study has been registered, ClinicalTrials.gov ID NCT05451264: https://clinicaltrials.gov/study/NCT05451264?cond=NCT05451264&rank=1.

Impact

A meta-analysis on the effects of early postnatal administration of corticosteroids concluded that the hypertensive risk was increased in infants, but that long-term studies should be carried out.

We show that early hydrocortisone administration after extremely preterm birth in a randomized trial is not associated with detrimental cardiovascular indices in children/adolescents, at least in one center of the trial

Thus, our study suggests that early markers of the risk of hypertension are not altered by hydrocortisone.