Rodríguez-Pinilla Elvira, Prieto-Merino David, Dequino Griselda, Mejías Consuelo, Fernández Paloma, Martínez-Frías María-Luisa
Centro de Investigación sobre Anomalías Congénitas (CIAC), Sección de Teratología Clínica y Servicio de Información sobre Teratógenos (SITTE), Instituto de Salud Carlos III, Madrid, España.
Med Clin (Barc). 2006 Sep 16;127(10):361-7. doi: 10.1157/13092436.
To study the effects of antenatal corticosteroids treatment to promote fetal lung maturation, on fetal growth, depending on the number of the courses administered.
The study was based on data from the Spanish Collaborative Study of Congenital Malformations (ECEMC), analysing a sample of 29,557 singleton liveborn infants without congenital defects. An stratified analysis by gestational age was performed to compare the weight, length and head circumference at birth, in the exposed and unexposed infants to dexamethasone/betamethasone. To control confounding factors (year of birth, maternal age, gestational age, parity, maternal smoking and/or alcohol consumption, gestational diabetes, non-gestational diabetes and other maternal chronic diseases) we used a general linear model with random effects, being the randomised variable the place of birth.
The exposure to more than one course of antenatal corticosteroids resulted in a significant reduction of birth weight, length and head circumference in singleton preterm infants. The birth weight decreased by 22% (p < 0.0001), the length 5% (p = 0.002) and the head circumference 6% (p = 0.0005). The treatment with only one course reduced also significantly the weight and length but not the head circumference. In addition, we observed a significant interaction between the treatment and gestational age at birth indicating that the effect of corticosteroids is stronger in the most premature babies.
In this retrospective analysis, the antenatal exposure to corticosteroids to promote fetal maturation is associated with diminished weight, length and head circumference in the premature newborn infant. This negative effect was greater in those premature babies exposed to multiple courses.
研究产前使用皮质类固醇促进胎儿肺成熟的治疗对胎儿生长的影响，该影响取决于给药疗程数。
本研究基于西班牙先天性畸形协作研究（ECEMC）的数据，分析了29557例无先天性缺陷的单胎活产婴儿样本。对接受地塞米松/倍他米松治疗组和未接受治疗组的婴儿，按胎龄进行分层分析，比较其出生时的体重、身长和头围。为控制混杂因素（出生年份、母亲年龄、胎龄、产次、母亲吸烟和/或饮酒、妊娠期糖尿病、非妊娠期糖尿病及其他母亲慢性病），我们使用了具有随机效应的一般线性模型，将出生地点作为随机变量。
单胎早产儿接受一个以上疗程的产前皮质类固醇治疗后，出生体重、身长和头围显著降低。出生体重下降22%（p<0.0001），身长下降5%（p = 0.002），头围下降6%（p = 0.0005）。仅接受一个疗程治疗也显著降低了体重和身长，但对头围无影响。此外，我们观察到治疗与出生时的胎龄之间存在显著交互作用，表明皮质类固醇对最早产婴儿的影响更强。
在这项回顾性分析中，产前使用皮质类固醇促进胎儿成熟与早产新生儿体重、身长和头围减小有关。这种负面影响在接受多个疗程治疗的早产婴儿中更大。
