Association between prophylactic hydrocortisone and focal intestinal perforations in preterm infants born before 28 weeks gestation: an observational propensity matched population study in England and Wales.

Authors

Alice Sara Aveline, Alex Bottle, Anna Milan, Mireille Toledano, Sabita N Uthaya, Chris Gale, Cheryl Battersby

Published in

Archives of disease in childhood. Fetal and neonatal edition. Oct 07, 2026. Epub Oct 07, 2026.

Abstract

To examine the association between prophylactic hydrocortisone, given to prevent bronchopulmonary dysplasia, and the risk of focal intestinal perforation (FIP) in preterm infants.
Retrospective cohort study using routinely-collected data from infants born between 2016 and 2023.
All English and Welsh neonatal units.
15 746 infants born at less than 28 weeks gestation and admitted to a neonatal unit. Infants were matched (exposed vs unexposed) using a propensity score comprising 17 variables.
Exposed infants received hydrocortisone for at least eight consecutive days beginning on postnatal day one or two. Unexposed infants did not receive hydrocortisone in line with this definition.
Primary outcome was FIP. Secondary outcomes included mortality, survival without FIP, bronchopulmonary dysplasia.
6.3% (999/15 746) infants were exposed to early hydrocortisone and 4.6% (722/15 746) had FIP. 2815 infants (988 exposed and 1827 unexposed) were included in the matched analysis; 47% girls, median gestational age of 26.0 weeks (IQR 24.6-26.9) and median birth weight of 815 g (IQR 674-965). There was no significant difference in risk of FIP (4.9% (48/988) exposed vs 6.1% (111/1827) unexposed, OR 0.79, 95% CI 0.55 to 1.14); findings were consistent in the sensitivity analyses. Early hydrocortisone was associated with increased mortality (21.3% (210/988) exposed vs 16.2% (295/1827) unexposed, OR 1.40, 95% CI 1.14 to 1.72).
Early prophylactic hydrocortisone from the first postnatal week was not associated with FIP. The observed association with higher mortality was a secondary finding in this observational study and requires cautious interpretation and further investigation.

PMID:
42843981
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.