LAUSR

Key Points Question What are the patterns of dexamethasone and prednisolone and methylprednisolone use in extremely preterm infants and are their use associated with 2-year outcomes? Findings In this cohort study including 828 extremely preterm infants from a multicenter randomized clinical trial, 38% of infants were treated with corticosteroids, with exposure rates decreasing as gestational age at birth increased. More infants were treated with dexamethasone, and exposure was shorter and earlier compared with prednisolone or methylprednisolone; longer duration of treatment with dexamethasone, but not prednisolone or methylprednisolone, was associated with worse neurodevelopmental outcomes at corrected age 2 years. Meaning These findings suggest that significant practice variation in postnatal corticosteroids treatment was common and that limiting exposure to dexamethasone may be associated with minimizing adverse neurodevelopmental outcomes.