Chronic use of steroids in premature infants has been associated with which condition?

• A. Cholestasis
• B. Nephrolithiasis
• C. Osteopenia
• D. Hypoglycemia

Answer: (C)

Chronic exposure to steroids in premature infants disrupts bone mineralization, leading to osteopenia. Glucocorticoids inhibit the formation and activity of osteoblasts and promote osteoblast and osteocyte apoptosis, shifting the balance toward bone resorption. They also decrease calcium absorption from the gut and increase urinary calcium loss, reducing the calcium available for bone formation. In the immediate postnatal period, preterm infants rely on rapid bone mineralization, so these steroid effects result in low bone mineral content and a risk of fractures—osteopenia of prematurity. The other conditions listed are not the typical consequence of chronic steroid use in this population: cholestasis relates more to liver function and certain nutritional factors, nephrolithiasis is not a common neonatal steroid-related issue, and steroids usually raise glucose levels rather than cause hypoglycemia.