Zelf-gerapporteerde klachten bij adolescenten die neonataal behandeld zijn met corticosteroiden
Rutten, M.A. van
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Neonatal glucocorticoid (GC) treatment, in particular dexamethasone (DEX), is used worldwide to treat chronic lung disease in prematurely born babies. Despite the effectiveness of DEX, increasing evidence indicates long-term adverse effects, including functional changes in the hypothalamus-pituitary- adrenal axis (HPA) and immune system responses. The GC hydrocortisone (HC) is administered in a minority of neonatal intensive care units. So far, no negative effects of HC were observed on the long term. In this study we are the first to examine the effects of neonatal treatment with DEX or HC on fatigue, pain, sleep, anxiety, depression and somatic symptoms, in individuals at adolescent age. A total of 124 prematurely born children were included in this study. Children treated with the glucocorticoids DEX (N= 32) or HC (N= 48 matched for gender, age, birth weight, grade of peri-intraventricular hemorrhage and duration of pregnancy. A reference group (the untreated condition) (N= 45) of prematurely children who had received no glucocorticoids treatment was included for comparison. Questionnaires about fatigue, quality of sleep, anxiety, depression and somatic symptoms were filled out. An algometer test was used to examine pain pressure threshold. Overall results showed no effect of treatment group on fatigue, pain, sleep, somatic symptoms, anxiety & depression. However, interaction effects and gender differences were obtained. Unexpectedly, DEX- and HC treated girls had less fatigue and sleep problems than girls from the reference group. However, DEX- and HC treated boys reported more sleep problems in comparison with the REF group. DEX boys had the highest pain pressure threshold and DEX girls have the lowest threshold in comparison with the HC and REF group. HC boys reported significantly poorer quality of sleep than REF boys. Despite the interaction effect and gender differences that indicate some interesting differences in treatment, in current cohort it has not been proved that DEX has more long-term adverse effects than HC. However, relations with HPA-as functioning and immune system response could not be made. Further research is necessary to examine whether treatment effects on symptom reports and pain threshold are related to HPA-as and immune system response characteristics at adolescent age.