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PERIPrem bundle: Prophylactic hydrocortisone

Prophylactic postnatal hydrocortisone is a relatively new protocol for most units. This will need recruitment and commitment of your unit’s Neonatal Consultant Body prior to approaching the process and training aspects of implementation so spend your time wisely.

Resources are available below to introduce the team to the evidence base but the in-depth papers can be found in our evidence summary by the PREMILOC team. Perhaps postnatal hydrocortisone can be used as part of a preterm admission bundle checklist?

We encourage you to look across the three “capsules” of Process, Training and Education and Communications and Engagement when planning and implementing any changes, we know from experience that action needs to be taken across all three capsules to see a progress. These areas will be covered in the unit-level training.

Pay attention to how you will embed and sustain the improvements you have made and you can use the embedding and sustaining change tool (coming soon) to shape your thinking in doing so.


We have a package of resources to support implementation of this PERIPrem bundle element. Please watch the video and download the resources to find out more.


Postnatal steroids resources

Please tell us a bit about yourself to download our PERIPrem resources

PERIPrem resources form
PERIPrem resources form


Links for more information

If you would like to understand more about the evidence behind this PERIPrem bundle element, the following papers, reviews and websites have more information.

Shaffer, Michele L., et al. “Effect of Prophylaxis for Early Adrenal Insufficiency Using Low-Dose Hydrocortisone in Very Preterm Infants: An Individual Patient Data Meta-Analysis.” (2019).