EDITORReferring to the paper entitled Early postnatal dexamethasone treatment and increased incidence of cerebral palsy by Shinwell et al¹, both its title and the first paragraph of the Discussion imply that the use of postnatal dexamethasone may lead to cerebral palsy. However, it is the misuse of the term "incidence" that gives rise to this interpretation. The authors did not, neither could they, provide incidence data. What they presented was cerebral palsy prevalence data.

If it is accepted that prevalence and not incidence data are provided, then a very different interpretation of the findings can be made. Supposing the cerebral impairment of cerebral palsy occurred prepartum, then the use of dexamethasone may have allowed these children to survive, whereas, had they received the placebo, they would have died before a diagnosis of cerebral palsy could be made. This would account for the higher prevalence of cerebral palsy . . . [Full text of this article]