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产前暴露于糖皮质激素至分娩的时间间隔对极低出生体重儿新生儿结局的影响。

The effects of the time interval from antenatal corticosteroid exposure to delivery on neonatal outcome of very low birth weight infants.

作者信息

Sehdev Harish M, Abbasi Soraya, Robertson Patricia, Fisher Lytia, Marchiano Dominic A, Gerdes Jeffrey S, Ludmir Jack

机构信息

Division of Maternal-Fetal Medicine and Newborn Pediatrics, Pennsylvania Hospital, 800 Spruce Street-2 Pine East, Philadelphia, PA 19107, USA.

出版信息

Am J Obstet Gynecol. 2004 Oct;191(4):1409-13. doi: 10.1016/j.ajog.2004.06.055.

Abstract

OBJECTIVE

The purpose of this study was to determine whether the interval between antenatal steroid exposure and delivery influences neonatal outcome in very low birth weight infants.

STUDY DESIGN

A retrospective review was performed of all live-born singleton infants who weighed between 500 and 1500 g and who were exposed to a partial course (1 dose) or a complete course (2 12-mg doses of betamethasone given 24 hours apart) of antenatal corticosteroids. Infants were divided into 4 groups, depending on the interval between the first dose of antenatal corticosteroids and delivery (<24 hours, between 24 and 48 hours, between 48 hours and 7 days, and >7 days). Logistic regression was used to control for differences between the 4 groups.

RESULTS

Three hundred twenty-five singleton deliveries were reviewed. Gestational age at delivery and birth weight were similar for all 4 groups. The babies in the last group were treated with antenatal corticosteroids at a slightly earlier gestational age. There was no statistical difference between the groups with respect to respiratory distress syndrome treated with surfactant, intraventricular hemorrhage, necrotizing enterocolitis, and deaths.

CONCLUSION

In infants who weighed 500 to 1500 g, the time interval between exposure to antenatal corticosteroids and delivery does not appear to affect neonatal outcome. Further studies should evaluate the effects of antenatal corticosteroids and the effects of the interval from exposure to delivery in very low birth weight infants.

摘要

目的

本研究旨在确定产前使用类固醇与分娩之间的间隔时间是否会影响极低出生体重儿的新生儿结局。

研究设计

对所有体重在500至1500克之间、接受过部分疗程(1剂)或完整疗程(2剂,每剂12毫克倍他米松,间隔24小时给药)产前皮质类固醇治疗的单胎活产婴儿进行回顾性研究。根据第一剂产前皮质类固醇与分娩之间的间隔时间(<24小时、24至48小时、48小时至7天、>7天)将婴儿分为4组。采用逻辑回归分析来控制4组之间的差异。

结果

共回顾了325例单胎分娩。所有4组的分娩孕周和出生体重相似。最后一组婴儿接受产前皮质类固醇治疗时的孕周稍早。在使用表面活性剂治疗的呼吸窘迫综合征、脑室内出血、坏死性小肠结肠炎和死亡方面,各组之间无统计学差异。

结论

对于体重在500至1500克的婴儿,产前暴露于皮质类固醇与分娩之间的时间间隔似乎不会影响新生儿结局。进一步的研究应评估产前皮质类固醇的影响以及极低出生体重儿从暴露到分娩的时间间隔的影响。

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