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Objective <p>To examine the variability in neonatologists’ screening and management practices of corticosteroid-induced adrenal insufficiency (adrenal suppression; AS) in the NICU.</p> Study design <p>A cross-sectional survey was disseminated nationally via REDCap<sup>®</sup> to 160 neonatologists who serve as members of Children’s Hospitals Neonatal Consortium. Descriptive statistics were used to capture variability in AS screening modalities, diagnostic tools, management approaches, and discharge planning.</p> Result <p>Of the 82 respondents, only 56.1% screen infants for AS following prolonged systemic corticosteroid exposure, 46.3% after 2–4 weeks, 59.8% utilizing ACTH stimulation testing. Only 2.4% screen after prolonged high dose inhaled corticosteroids, reflecting uncertainty regarding their suppressive potential. Additionally, only 30.5% provide structured caregiver AS education at discharge.</p> Conclusion <p>Variable nationwide screening and management of adrenal suppression in the NICU underscores uncertainty and inconsistency in practice, revealing the need for clinical guidelines to optimize care.</p>

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Neonatologists’ practices in screening and managing corticosteroid-induced adrenal insufficiency in the NICU- a multicenter study

  • 期刊论文

  • 发表日期：

    2026年2月23日

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  • Sean Christopher Watson,
  • Parvesh Mohan Garg,
  • Cathrine Constantacos

摘要

Objective

To examine the variability in neonatologists’ screening and management practices of corticosteroid-induced adrenal insufficiency (adrenal suppression; AS) in the NICU.

Study design

A cross-sectional survey was disseminated nationally via REDCap® to 160 neonatologists who serve as members of Children’s Hospitals Neonatal Consortium. Descriptive statistics were used to capture variability in AS screening modalities, diagnostic tools, management approaches, and discharge planning.

Result

Of the 82 respondents, only 56.1% screen infants for AS following prolonged systemic corticosteroid exposure, 46.3% after 2–4 weeks, 59.8% utilizing ACTH stimulation testing. Only 2.4% screen after prolonged high dose inhaled corticosteroids, reflecting uncertainty regarding their suppressive potential. Additionally, only 30.5% provide structured caregiver AS education at discharge.

Conclusion

Variable nationwide screening and management of adrenal suppression in the NICU underscores uncertainty and inconsistency in practice, revealing the need for clinical guidelines to optimize care.