Renolleau C, Toumazi A, Bourmaud A, et al. - Researchers sought to define a nomogram of serum cortisol values before 24 hours of postnatal life for extremely preterm infants. In addition, they investigated if and how baseline cortisol values influence the benefit/risk ratio of prophylactic hydrocortisone to improve survival without bronchopulmonary dysplasia (BPD). A predefined secondary analysis was performed of the multicenter randomized controlled PREMILOC trial that included inborn infants delivered before 28 weeks of gestation. They determined nomograms of baseline serum cortisol values estimated in 325 enrolled patients for male and female neonates and correlated them with perinatal events. Findings revealed that baseline cortisol levels were not predictive of BPD-free survival in HC-treated infants born extremely preterm. However, a greater risk of severe intraventricular hemorrhage and spontaneous intestinal perforation was observed in HC-treated infants in correlation with high cortisol levels early after birth, therefore a lower benefit/risk ratio for the treatment.