Banks Beverly A, Macones George, Cnaan Avital, Merrill Jeffrey D, Ballard Philip L, Ballard Roberta A
Department of Pediatrics, University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, Division of Neonatology, Philadelphia, PA 19104, USA.
J Perinatol. 2002 Mar;22(2):101-7. doi: 10.1038/sj.jp.7210604.
Determine whether the increased neonatal mortality following repeated courses of antenatal corticosteroids (ANCS), observed in the Thyrotropin-Releasing Hormone (TRH) Trial, was related to confounding maternal risk factors or specific preterm morbidities.
A post hoc analysis of 595 TRH trial neonates, 26 to 32 weeks' gestation, studied the association between > or =3 courses ANCS and mortality. Potential confounding maternal factors and preterm morbidities were evaluated using logistic regression and log likelihood modeling.
Mortality was 9.2% after > or =3 courses (13/141) vs. 4.8% after 1 or 2 courses (22/454). This association was not explained by maternal factors, or other common preterm morbidities. However, 15/141 infants receiving > or =3 courses (10.6%) had early severe lung disease (ESLD) with 10 deaths, compared to 16/454 of the 1- to 2-course infants (3.5%) with 7 deaths (odds ratio 3.5, p<0.001).
ESLD, but not maternal risk factors, was associated with increased mortality in preterm infants after > or =3 courses ANCS.
在促甲状腺激素释放激素（TRH）试验中观察到，多次产前使用糖皮质激素（ANCS）后新生儿死亡率增加，本研究旨在确定这是否与产妇混杂风险因素或特定的早产并发症有关。
对595例妊娠26至32周的TRH试验新生儿进行事后分析，研究≥3疗程ANCS与死亡率之间的关联。使用逻辑回归和对数似然模型评估潜在的产妇混杂因素和早产并发症。
≥3疗程后的死亡率为9.2%（13/141），而1或2疗程后的死亡率为4.8%（22/454）。这种关联无法用产妇因素或其他常见的早产并发症来解释。然而，接受≥3疗程的141例婴儿中有15例（10.6%）患有早期严重肺部疾病（ESLD），其中10例死亡，而1至2疗程的454例婴儿中有16例（3.5%）患有ESLD，7例死亡（比值比3.5，p<0.001）。
≥3疗程ANCS后，早产婴儿死亡率增加与ESLD有关，而非产妇风险因素。
