Sybulski S, Maughan G B
Am J Obstet Gynecol. 1976 May 15;125(2):239-43. doi: 10.1016/0002-9378(76)90600-1.
The aim of this study was to determine whether there is a decrease in fetal cortisol levels associated with the respiratory distress syndrome (RDS). Eighteen newborn infants of less than 37 weeks' gestation who developed moderate to severe forms of RDS did have a significantly lower (P less than 0.02) mean cord plasma cortisol concentration at birth than that observed in 67 unaffected infants of similar gestational age; mean values +/- standard errors were 3.36 +/- 0.42 and 5.58 +/- 0.43 mug per 100 ml, respectively. However, whether or not RDS developed in neonates appeared to depend more upon the degree of prematurity (with a 71.5% incidence in gestations of less than 32 weeks compared to 17.1% in those of 32 to less than 37 weeks) than upon cortisol levels at delivery. Bood cortisol levels in the first days of life of four infants with RDS were considerably increased in comparison to those at birth. Mean cord plasma cortisol concentrations increased with duration of pregnancy, with the previously observed value for term infants (of 37 or more weeks) being approximately twice that for infants of less than 32 weeks' gestation. These findings appear to justify carefully controlled studied with antepartum glucocorticoid administration with the aim of reducing the incidence of RDS in premature newborn infants.
本研究的目的是确定与呼吸窘迫综合征（RDS）相关的胎儿皮质醇水平是否降低。18例孕龄小于37周且发展为中度至重度RDS的新生儿出生时脐血血浆皮质醇平均浓度显著低于（P<0.02）67例孕龄相似的未受影响婴儿；平均值±标准误分别为每100ml 3.36±0.42和5.58±0.43μg。然而，新生儿是否发生RDS似乎更多地取决于早产程度（孕龄小于32周的发病率为71.5%，而32至小于37周的为17.1%），而非分娩时的皮质醇水平。与出生时相比，4例患有RDS的婴儿出生后第一天的血皮质醇水平显著升高。脐血血浆皮质醇平均浓度随孕期延长而升高，之前观察到的足月儿（37周或以上）的值约为孕龄小于32周婴儿的两倍。这些发现似乎证明了为降低早产新生儿RDS发病率而进行的产前糖皮质激素给药的严格对照研究是合理的。
