Context

Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth, with a reported incidence of 40% in extremely preterm infants (<28 weeks gestation).1 BPD is associated with an increased risk of long-term pulmonary and neurodevelopmental morbidity.2 The corticosteroid dexamethasone reduces the risk of BPD in preterm infants, but its use has been discouraged due to the risk for short-term (gastrointestinal perforation) and long-term (cerebral palsy) adverse effects.3

The corticosteroid hydrocortisone has been suggested as a safe and effective alternative for dexamethasone but, to date, studies comparing hydrocortisone to placebo have …