Original Investigation

Early Prophylactic Hydrocortisone and Bronchopulmonary Dysplasia–Free Survival in Extremely Preterm Infants

JAMA Network Open 10.1001/jamanetworkopen.2025.60146

February 19, 2026 at 11:00 AM EST

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After guideline implementation, has early prophylactic hydrocortisone improved survival without bronchopulmonary dysplasia (BPD) in extremely preterm infants born in Sweden, and is it safe to use?In this cohort study using prospectively collected data from 1106 infants from a national register, introduction of prophylactic hydrocortisone was followed by an increased likelihood of survival without BPD. There was no significant increase in severe neonatal morbidities.These findings, based on clinical implementation data, suggest alignment with previous similar studies supporting the benefits and safety of early prophylactic hydrocortisone treatment.

Corresponding Author: Veronica Smedbäck, MS in Medicine, PhD-student, Department of Biomedical and Clinical Sciences, Division of Children’s and Women’s Health, Linköping University, Campus US, 581 85 Linköping, Sweden (veronica.smedback@liu.se).

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