Post-natal Steroid Exposure in Very Low Birthweight Neonates and Associations with Acute Kidney Injury

Abstract Objective: The relationship between adrenal insufficiency (AI), post-natal steroids (PNS) and neonatal acute kidney injury (AKI) remains understudied. We aimed to investigate associations between PNS and AKI in very low birthweight (VLBW) neonates, hypothesizing PNS is independently associated with reduced AKI. Study Design: We conducted a single-center retrospective review of VLBW infants. Comparisons were made between those with and without PNS exposure. Associations between PNS exposure and AKI were evaluated using generalized linear mixed-modeling adjusted for confounders. Result: Of 567 neonates, 97 (17.1%) were exposed to PNS and 130 (22.9%) experienced AKI. Infants with PNS had lower gestational age, birthweight, Apgar scores, and experienced more AI versus those without PNS (all p <0.05). PNS was independently associated with AKI (aRR 1.72, 95% CI 1.09 – 2.72). Conclusion: PNS exposure is independently associated with increased AKI in VLBW neonates. Further analysis is needed to investigate the role of AI and AKI.