OBJECTIVE: Bronchopulmonary dysplasia (BPD) still contributes to be a major cause of neonatal mortality and short- as well as long-term respiratory morbidity in extremely preterm infants. Systemic corticosteroid use for BPD remains controversial, mainly because of the concern for its adverse effects. The study was conducted to assess the effect of systemic corticosteroid treatment on BPD in Cipto Mangunkusumo Hospital.
METHOD: This descriptive retrospective study was held in Cipto Mangunkusumo Hospital from January to December 2018. The data taken was the use of systemic corticosteroid as a treatment and after-treatment outcomes. The outcomes were namely the rate of BPD survival rate, free from oxygen and ventilation support in 10 days after treatment, length of hospitalization, and potential adverse effects related to systemic corticosteroid treatment.
RESULT: Fifty-two patients with BPD were enrolled in this study, 26.9% (14/52) patients had systemic dexamethasone treatment, 28.8% (15/52) had systemic hydrocortisone treatment, and 44% (23/52) were not treated with corticosteroids. Survival rate with BPD was 71.42% with dexamethasone treatment, 86.67% with hydrocortisone treatment, and 30.43% without systemic corticosteroid treatment. Free from oxygen/ventilation support in 10 days after treatment rate was 35.71% with dexamethasone treatment and 13.33% with hydrocortisone treatment. Those with hydrocortisone treatment got longer hospitalization day (62[36-152]) compared to those with dexamethasone (52[32-146]). The potential adverse effects of the use of dexamethasone and  hydrocortisone ranging from gastrointestinal bleeding (14.28% and 13.33%) to necrotizing enterocolitis (7.14% and 6.67%), intraventricular haemorrhage (14.28% in dexamethason group), hyperglycaemia (6.67% in hydrocortisone group), hypertension (7.14% in dexamethasone treatment), pneumonia  (7.14% and 6.67%), and sepsis (14.28% and 6.67%).
CONCLUSION: The use of postnatal corticosteroids in preterm infants is still controversial. The benefits, however, are associated with range of adverse short and long-term effects. Thus, randomized control trial research is needed to have better understanding of BPD and postnatal corticosteroids.