French Noel P, Hagan Ronald, Evans Sharon F, Mullan Annie, Newnham John P
Department of Neonatal Paediatrics, King Edward Memorial Hospital, Subiaco, Perth, Australia.
Am J Obstet Gynecol. 2004 Mar;190(3):588-95. doi: 10.1016/j.ajog.2003.12.016.
This study was undertaken to determine the effects of repeated courses of antenatal corticosteroids on childhood behavior and disabilities, including cognitive delay and cerebral palsy.
Nonrandomized regional cohort of 541 very preterm infants born in Western Australia from singleton pregnancies and alive at 3 years were included in the study.
Physical, cognitive, and psychological assessments up to 6 years.
Increasing numbers of antenatal corticosteroid courses were associated with a reduction in the rate of cerebral palsy. Three or more courses were also associated with increased rates of aggressive/destructive, distractible, and hyperkinetic behavior and these effects were present at both ages 3 and 6 years. Measures of internalizing behavior and intelligence quotient were unaffected by antenatal corticosteroid use.
Repeated antenatal courses of corticosteroids may protect against cerebral palsy but are associated with hyperactivity later in childhood.
本研究旨在确定重复使用产前皮质类固醇对儿童行为和残疾的影响，包括认知延迟和脑瘫。
本研究纳入了西澳大利亚州541名单胎妊娠的极早产儿，这些婴儿均存活至3岁，属于非随机区域队列研究。
对儿童进行长达6年的身体、认知和心理评估。
产前皮质类固醇疗程数量的增加与脑瘫发生率的降低相关。三个或更多疗程还与攻击/破坏性行为、注意力不集中和多动行为发生率的增加相关，且这些影响在3岁和6岁时均存在。内化行为指标和智商不受产前皮质类固醇使用的影响。
重复使用产前皮质类固醇疗程可能预防脑瘫，但与儿童后期的多动相关。
