95 Assessing the effects of prophylactic hydrocortisone in the Canadian Neonatal Network
Bibliographic record
Abstract
Abstract Background A recent trial and meta-analysis have shown that prophylactic hydrocortisone is associated with lower rates of bronchopulmonary dysplasia (BPD) among extremely preterm infants. Objectives To evaluate the real-world effects of prophylactic hydrocortisone (pHCT) on the odds of death or BPD. Secondary objectives assessed respiratory and safety outcomes. Design/Methods A multi-center retrospective cohort study of infants born <28 weeks gestation and admitted to a Neonatal Intensive Care Unit in the Canadian Neonatal Network 2019-2023. Infants who received pHCT were compared 1:1 to propensity score matched controls who did not. The primary outcome was death or moderate to severe BPD. Hierarchical outcomes were explored with win odds analysis applied. Logistic regression analysis was used to calculate adjusted odds ratios (aOR) of primary and secondary outcomes. Results The study population included 361 infants per group with median gestational age 25 weeks (IQR 24, 26) and baseline characteristics were balanced between groups (absolute standardized differences <0.1). There was no difference in the odds of death or moderate to severe BPD nor was there a difference in duration of invasive and non-invasive ventilation (Table 1). There was lower use of postnatal steroids and treatment of patent ductus arteriosus in the pHCT group, but no significant difference in other safety outcomes was observed (Table 2). Hierarchical composite endpoint analysis also did not show significant difference in the primary outcome with win odds (95% CI) of 1.02 (0.85, 1.28). Conclusion Prophylactic hydrocortisone was not associated with reductions in mortality nor moderate to severe BPD, but was associated with lower use of additional postnatal steroids and treatment of patent ductus arteriosus.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.031 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.007 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".