For long, medicos believed that treating premature babies with hydrocortisone, a steroid, would help the newborn fight inflammation and prevent lung disease. But now, a new study at Johns Hopkins Children's Center has voiced its doubts on the effectiveness of this medical practice.
Researchers claimed that such treatment doesn't offer much benefit and also low cortisol levels are not even necessarily harmful.
On the other hand, high cortisol levels, apparently increase the risk of dangerous bleeding in the brain and it is required that babies should be monitored aggressively to ward off life-threatening complications.
Premature babies and adults having a condition, called relative adrenal insufficiency, have abnormally low levels of the stress hormone cortisol and it is usually treated by hydrocortisone therapy in the newborns.
The new findings, however, shed new light on the clinical meaning of low cortisol levels in preemies. It shows that contrary to common belief, low blood concentrations of this hormone do not put extremely low-birth-weight babies (those born weighing less than 2.2 pounds) at higher risk for retinopathy of prematurity — a potentially blinding eye condition — inflammation and lung disease.
No difference was found in health outcomes between babies with low cortisol levels who were treated with hydrocortisone and those given a placebo.
While hydrocortisone didn't have adverse effects on a baby's health, it also did nothing to prevent or reduce respiratory diseases, infections, hemorrhages or retinopathy.
"We were intrigued and somewhat surprised, but contrary to what we expected, low cortisol levels do not appear to be dangerous and may actually be the norm in premature babies. What this means is we should really think twice before rushing to treatment with hydrocortisone in our effort to 'correct' these low levels," said study lead investigator Susan Aucott, M.D., a neonatologist at Hopkins Children's.
It may be surprising, but the findings are not entirely counterintuitive, because in- utero babies have naturally low cortisol levels.
"This may mean that, in a way, low cortisol levels are normal, and premature babies maintain them low, as they would have been in the womb," said Aucott.
After comparing the cortisol levels of 311 extremely low-birth-weight preemies immediately after birth and one week after birth, researchers found low cortisol levels did not increase the risk for adverse short-term outcomes or death.
The study was published in the latest issue of Pediatrics.