Chapman S J, Hauth J C, Bottoms S F, Iams J D, Sibai B, Thom E, Moawad A H, Thurnau G R
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, 35233-7333, USA.
Am J Obstet Gynecol. 1999 Mar;180(3 Pt 1):677-82. doi: 10.1016/s0002-9378(99)70272-3.
The aim of the study was to determine the effects of antenatal maternal corticosteroid treatment on selected neonatal outcomes in infants weighing </=1000 g at birth after preterm rupture of membranes.
In a 1-year (1992-1993) prospective observational study, the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network collected outcome data for 766 infants who did not have a major fetal anomaly and who had a birth weight </=1000 g (378 were born after preterm rupture of membranes). Only fetuses deemed potentially viable by the obstetrician were included in our analysis. Selected neonatal outcomes were compared between mothers who did and did not receive antenatal corticosteroids. Logistic regression variables included birth weight, sex, race, amnionitis, tocolytic therapies, mode of delivery, and surfactant use.
Two hundred fourteen of the 378 infants whose mothers had preterm rupture of membranes were deemed potentially viable; 62 of these mothers received antenatal steroids and 152 did not. Groups were similar with respect to gestational age, birth weight, race, amnionitis, and delivery mode. Women who received antenatal steroids were more likely to have received tocolysis (P <.001). Univariate and regression analyses controlling for multiple confounders confirmed no neonatal benefits of maternal corticosteroid use.
Corticosteroid treatment in women with preterm rupture of membranes was of no apparent benefit to neonates weighing </=1000 g.
本研究旨在确定产前母体使用糖皮质激素治疗对胎膜早破后出生体重≤1000 g的婴儿某些新生儿结局的影响。
在一项为期1年（1992 - 1993年）的前瞻性观察研究中，美国国立儿童健康与人类发展研究所母胎医学单位网络收集了766例无严重胎儿畸形且出生体重≤1000 g婴儿的结局数据（其中378例为胎膜早破后出生）。我们的分析仅纳入了被产科医生认为有潜在存活能力的胎儿。比较了接受和未接受产前糖皮质激素治疗的母亲的某些新生儿结局。逻辑回归变量包括出生体重、性别、种族、羊膜炎、tocolytic疗法、分娩方式和表面活性剂的使用情况。
378例母亲胎膜早破的婴儿中，214例被认为有潜在存活能力；其中62例母亲接受了产前类固醇治疗，152例未接受。两组在胎龄、出生体重、种族、羊膜炎和分娩方式方面相似。接受产前类固醇治疗的女性更有可能接受了tocolysis（P<.001）。控制多个混杂因素的单变量和回归分析证实，母体使用糖皮质激素对新生儿没有益处。
胎膜早破女性使用糖皮质激素治疗对出生体重≤1000 g的新生儿没有明显益处。
