Reference: The role of corticosteroids in a preterm infant with lung pathology in the first three months of life.

Corticosteroids are helpful in the treatment of preterm neonates at risk of bronchopulmonary dysplasia (BPD). However, its usefulness depends on patient selection, the timing of intervention with a corticosteroid, and choice of corticosteroid. In making these clinical choices, one must consider both short and long-term outcomes. Although corticosteroid use has been available for decades in preterm neonatal care, many aspects of corticosteroid use are unresolved due to limited research. Corticosteroids cause upregulation of anti-inflammatory, inhibiting pro-inflammatory mediators at the genomic level. Furthermore, the benefits of using corticosteroids should outweigh the known risks. Here we will discuss the current literature to guide clinical practice—a literature search for evidence through the clinical database on EMBASE, Medline, PubMed, and Cochrane. The keywords are bronchopulmonary dysplasia, corticosteroids, and prematurity.Limitations.There is bias due to limited research available to provide a high level of scientific evidence on the use of different modes of administration, other agents compared to the systemic use of dexamethasone. Conclusion.The consensus in the prevention of BPD is selective treatment after one week of life with dexamethasone. There is limited evidence to suggest the role of prophylaxis hydrocortisone in preventing BPD and advise to be considered in centers with a high risk of BPD. An extensive study into prophylaxis hydrocortisone for prevention of BDP and long-term outcome appears to be promising.The role of instilled steroids with surfactants at birth appears promising in the single-center study. A multicentre double-blinded randomized intratracheal budesonide use at delivery will be valuable.