Indeed, lower cortisol levels or a diminished cortisol response to ACTH have been associated with the development of BPD.1 In addition, various exogenous glucocorticoids may have different targets, in example reduced mortality rate for hydrocortisone and more inflammatory-related targets for dexamethasone.14 The prophylactic approach to preventing adrenal insufficiency was reconsidered in the early 2000s in response to the adverse neurodevelopmental effects reported following the use of dexamethasone, the main glucocorticoid used to prevent BPD at the time. Here, POMC is linked to bronchopulmonary dysplasia.