de Zegher F, de Vries L, Pierrat V, Daniels H, Spitz B, Casaer P, Devlieger H, Eggermont E
Department of Pediatrics, University Hospital Gasthuisberg, Leuven, Belgium.
Pediatr Res. 1992 Aug;32(2):212-4. doi: 10.1203/00006450-199208000-00017.
The maternal administration of betamethasone and thyrotropin releasing hormone (TRH) to accelerate the maturation of the fetus is an increasingly adopted strategy to prevent neonatal morbidity in preterm infants. The effect of this prenatal treatment on the neural maturation of the infant was assessed by measuring somatosensory evoked potentials (SEP) in preterm infants (gestational age 29-36 wk) on the 1st postnatal day, at the age of 1 wk, and before discharge. The N1 latency values of the SEP obtained in 14 infants who were exposed prenatally to betamethasone/TRH were compared with the N1 latencies measured in 12 control infants. On the 1st postnatal day, the N1 latencies in the betamethasone/TRH-treated infants were strikingly shorter (p less than 0.01) than in the controls. However, at the age of 1 wk and at discharge, the N1 latency values of both groups were similar. In conclusion, the present study provides the first solid evidence for the concept that the prenatal exposure to betamethasone/TRH accelerates the SEP-assessed neural maturation of the human fetus, that this prenatal acceleration is followed by a compensatory relative deceleration during the early neonatal period, and that the subsequent SEP-assessed neural maturation proceeds at a normal velocity.
母体给予倍他米松和促甲状腺激素释放激素（TRH）以加速胎儿成熟是一种越来越多地被采用的预防早产儿新生儿发病的策略。通过测量出生后第1天、1周龄和出院前的早产儿（胎龄29 - 36周）的体感诱发电位（SEP），评估这种产前治疗对婴儿神经成熟的影响。将14例产前暴露于倍他米松/TRH的婴儿获得的SEP的N1潜伏期值与12例对照婴儿测量的N1潜伏期进行比较。出生后第1天，接受倍他米松/TRH治疗的婴儿的N1潜伏期明显短于对照组（p小于0.01）。然而，在1周龄和出院时，两组的N1潜伏期值相似。总之，本研究为以下概念提供了首个确凿证据：产前暴露于倍他米松/TRH可加速人类胎儿经SEP评估的神经成熟，这种产前加速在新生儿早期之后会有一个代偿性的相对减速，且随后经SEP评估的神经成熟以正常速度进行。
