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产前暴露于倍他米松:纳入随机对照试验31年后的心理功能和健康相关生活质量

Antenatal exposure to betamethasone: psychological functioning and health related quality of life 31 years after inclusion in randomised controlled trial.

作者信息

Dalziel Stuart R, Lim Vanessa K, Lambert Anthony, McCarthy Dianne, Parag Varsha, Rodgers Anthony, Harding Jane E

机构信息

Clinical Trials Research Unit, University of Auckland, Private Bag 92019, Auckland, New Zealand.

出版信息

BMJ. 2005 Sep 24;331(7518):665. doi: 10.1136/bmj.38576.494363.E0. Epub 2005 Sep 5.

Abstract

OBJECTIVES

To determine if antenatal exposure to betamethasone for the prevention of neonatal respiratory distress syndrome alters psychological functioning and health related quality of life in adulthood.

DESIGN

Follow-up of the first and largest double blind, placebo controlled, randomised trial of a single course of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome.

SETTING

Tertiary obstetric hospital in Auckland, New Zealand.

PARTICIPANTS

192 adult offspring, mean age 31 years, of mothers who took part in a randomised controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome (87 exposed to betamethasone and 105 exposed to placebo).

INTERVENTIONS

Mothers received two doses of betamethasone or placebo 24 hours apart.

MAIN OUTCOME MEASURES

Cognitive functioning assessed with Wechsler abbreviated scale of intelligence; working memory and attention assessed with Benton visual retention test, paced auditory serial addition test, and Brown attention deficit disorder scale; psychiatric morbidity assessed with Beck depression inventory II, state-trait anxiety inventory, and schizotypy traits questionnaire; handedness assessed with Edinburgh handedness inventory; health related quality of life assessed with short form 36 health survey.

RESULTS

No differences were found between groups exposed to betamethasone and placebo in cognitive functioning, working memory and attention, psychiatric morbidity, handedness, or health related quality of life.

CONCLUSIONS

Prenatal exposure to a single course of betamethasone does not alter cognitive functioning, working memory and attention, psychiatric morbidity, handedness, or health related quality of life in adulthood. Obstetricians should continue to use a single course of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome.

摘要

目的

确定产前使用倍他米松预防新生儿呼吸窘迫综合征是否会改变成年后的心理功能和与健康相关的生活质量。

设计

对第一项也是规模最大的一项关于单疗程产前倍他米松预防新生儿呼吸窘迫综合征的双盲、安慰剂对照随机试验进行随访。

地点

新西兰奥克兰的三级产科医院。

参与者

192名成年后代,母亲参与了产前倍他米松预防新生儿呼吸窘迫综合征的随机对照试验,平均年龄31岁(87名暴露于倍他米松,105名暴露于安慰剂)。

干预措施

母亲们相隔24小时接受两剂倍他米松或安慰剂。

主要观察指标

用韦氏智力简表评估认知功能;用本顿视觉保持测验、听觉连续加法测验和布朗注意力缺陷障碍量表评估工作记忆和注意力;用贝克抑郁量表第二版、状态-特质焦虑量表和分裂型特质问卷评估精神疾病发病率;用爱丁堡利手量表评估利手情况;用简短健康调查问卷评估与健康相关的生活质量。

结果

在认知功能、工作记忆和注意力、精神疾病发病率、利手情况或与健康相关的生活质量方面,暴露于倍他米松和安慰剂的组之间未发现差异。

结论

产前单疗程暴露于倍他米松不会改变成年后的认知功能、工作记忆和注意力、精神疾病发病率、利手情况或与健康相关的生活质量。产科医生应继续使用单疗程产前倍他米松预防新生儿呼吸窘迫综合征。

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