International Journal of Medical Advances and Discoveries

International Journal of Medical Advances and Discoveries | Vol. 16, No. 12, December 2025 | pp. 86–94

DOI: 10.46882/2025/IJMAD/000111

Original Research Article

Title: Long-Term Neurodevelopmental Outcomes of Preterm Infants Managed with Early Prophylactic Hydrocortisone Infusion

Names of Authors: Mariam O. Bello¹, William J. Sterling², Chidi E. Okafor¹

Authors’ Affiliations: ¹Department of Pediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria; ²Division of Neonatal-Perinatal Medicine, Boston Children's Hospital, Boston, USA

Abstract: Bronchopulmonary dysplasia (BPD) is a critical driver of mortality in extremely preterm infants. While systemic corticosteroids effectively decrease BPD incidence, widespread clinical concern persists regarding adverse neurodevelopmental outcomes, particularly cerebral palsy. This multi-center prospective cohort study investigated the 24-month corrected age neurodevelopmental outcomes of extremely low birth weight (ELBW) infants (birth weight <1000 g, gestational age <28 weeks; n = 210) who received early low-dose prophylactic hydrocortisone (0.5 mg/kg twice daily for 12 days) compared to an untreated matched control cohort. The primary outcome was neurodevelopmental impairment (NDI), defined via the Cognitive, Language, and Motor composite scores of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). At 24 months of corrected age, no significant differences in mean cognitive composite scores (94.2 ± 11.5 vs. 93.8 ± 12.1, p = 0.81) or motor composite scores (91.6 ± 10.8 vs. 92.1 ± 11.3, p = 0.74) were observed between the hydrocortisone and control cohorts. The overall incidence of cerebral palsy remained statistically identical between groups (4.8% vs. 5.7%, p = 0.76). Conversely, the hydrocortisone-treated infants demonstrated a significant reduction in BPD severity and post-discharge oxygen supplementation needs (p = 0.01). Early prophylactic hydrocortisone administration in ELBW infants provides valuable pulmonary protection without increasing the long-term risk of neurodevelopmental impairment at two years of corrected age.

Keywords: Preterm infants, Hydrocortisone prophylaxis, Neurodevelopmental outcome, Bronchopulmonary dysplasia, Cerebral palsy, Bayley scales

Manuscript Timeline: Received: September 05, 2025; Revised: October 18, 2025; Accepted: November 11, 2025; Published: December 16, 2025

Citation: Bello, M. O., Sterling, J. W., & Okafor, C. E. (2025). Long-Term Neurodevelopmental Outcomes of Preterm Infants Managed with Early Prophylactic Hydrocortisone Infusion. International Journal of Medical Advances and Discoveries, 16(12), 86–94. doi.org

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