Rehan V K
Brown University School of Medicine, Memorial Hospital of Rhode Island, Pawtucket 02860, USA.
Indian J Pediatr. 1996 Sep-Oct;63(5):599-608. doi: 10.1007/BF02730802.
Antenatal corticosteroid administration has been unequivocally demonstrated to reduce neonatal morbidity and mortality. In addition to its well-documented role in reducing respiratory distress syndrome, evidence is accumulating indicating the global maturational effect of this therapy in the growing fetus. New data demonstrates, the hitherto relatively not well known, beneficial effects of this mode of therapy on renal, cardiovascular, gastrointestinal, endocrinal and cerebral maturation. Despite its well proven efficacy and safety, this therapy is used only in a small fraction of eligible mothers. In this article, biological basis of antenatal steroids use, clinical benefits including those to extremely premature infants, indications for their administration, treatment regimens, practice variations in their administration, cost analysis, and some directions for future research are reviewed. It is hoped that given the evidence reviewed in this article, the use of antenatal steroids administration in proper clinical settings will increase with a significant impact in reducing the neonatal morbidity and mortality.
产前使用皮质类固醇已被明确证明可降低新生儿发病率和死亡率。除了其在降低呼吸窘迫综合征方面的充分记录作用外，越来越多的证据表明这种疗法对发育中的胎儿具有全面的成熟作用。新数据表明，这种治疗方式对肾脏、心血管、胃肠道、内分泌和大脑成熟具有迄今相对不太为人所知的有益效果。尽管其疗效和安全性已得到充分证实，但这种疗法仅在一小部分符合条件的母亲中使用。本文综述了产前使用类固醇的生物学基础、临床益处（包括对极早产儿的益处）、给药指征、治疗方案、给药的实践差异、成本分析以及未来研究的一些方向。希望鉴于本文所综述的证据，在适当的临床环境中使用产前类固醇将增加，对降低新生儿发病率和死亡率产生重大影响。
