Friedman Smadar, Shinwell Eric S
Department of Neonatology, Kaplan Medical Center, PO Box 1, Rehovot 76100, Israel.
Clin Perinatol. 2004 Sep;31(3):529-44. doi: 10.1016/j.clp.2004.04.016.
In recent years, scientific evidence has accumulated on the potential neuro-toxic effects of perinatal steroid therapy on the incompletely developed brain; therefore, much effort has been directed toward finding the optimal regimen that may reduce lung disease without incurring significant brain injury in fetuses and preterm infants. Current recommendations of the NIH endorse a single course of prenatal steroids in cases of imminent preterm delivery. Postnatal steroid therapy should be limited, according to the American Association of Pediatrics Guide-lines, to selected clinical cases after the first week of life. These cautions aim to decrease possible harmful effects that could affect short- and long-term neuro-developmental outcome in this high-risk population.
近年来,关于围产期类固醇疗法对发育不完全的大脑潜在神经毒性作用的科学证据不断积累;因此,人们付出了很多努力来寻找最佳方案,以减少肺部疾病,同时又不会对胎儿和早产儿造成重大脑损伤。美国国立卫生研究院目前的建议支持在即将早产的情况下使用单一疗程的产前类固醇。根据美国儿科学会指南,出生后类固醇疗法应仅限于出生后第一周后的特定临床病例。这些注意事项旨在减少可能影响这一高危人群短期和长期神经发育结果的有害影响。