Polyakov Alex, Cohen Saul, Baum Marita, Trickey Donna, Jolley Damien, Wallace Euan M
Maternal-Fetal Medicine Unit, Monash Medical Centre, Monash University, Clayton, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2007 Feb;47(1):42-5. doi: 10.1111/j.1479-828X.2006.00677.x.
The administration of antenatal corticosteroids to women at risk of preterm birth is an important component of care for such women. However, inevitably, attempts to maximise the number of women who receive corticosteroids ahead of preterm birth will also expose women perceived at risk who subsequently deliver at term. These women have not been previously quantified.
To describe antenatal corticosteroid prescribing practices at a single institution over a seven-year period.
Interrogation of an electronic birthing outcome system supplemented by hand-searching of medical records, recording all women birthing before 34 weeks and all women with a hospital admission before 34 weeks but birthing after 34 weeks. The number of women receiving antenatal corticosteroids in each of these groups was recorded, and trends between groups and over time were analysed using logistic regression.
While the total number of women receiving antenatal corticosteroids in our institution has risen over the last seven years, the proportion of women receiving antenatal corticosteroids who deliver between 24 and 35 weeks has increased inconsistently and modestly (average increase 12% per year (95% CI: 6-19%, P < 0.001). In contrast, the number of women receiving antenatal corticosteroids who subsequently deliver after 34 weeks has increased consistently, with an average increase rate of 21% per year (95% CI: 16-25%, P < 0.001).
Increasing numbers of women birthing after 34 weeks in our hospital are receiving antenatal corticosteroids before 34 weeks. The long-term implications of this are not currently clear.
对有早产风险的妇女使用产前皮质类固醇是此类妇女护理的重要组成部分。然而，不可避免地，试图使在早产前接受皮质类固醇的妇女数量最大化，也会使那些被认为有风险但随后足月分娩的妇女暴露于此。此前尚未对此类妇女进行量化。
描述一家机构在七年时间里的产前皮质类固醇处方情况。
查询电子分娩结局系统，并人工查阅病历进行补充，记录所有在34周前分娩的妇女以及所有在34周前入院但在34周后分娩的妇女。记录这些组中接受产前皮质类固醇的妇女数量，并使用逻辑回归分析组间和随时间的趋势。
在过去七年中，我们机构接受产前皮质类固醇的妇女总数有所增加，但在24至35周之间分娩的接受产前皮质类固醇的妇女比例增加不一致且增幅较小（平均每年增加12%（95%置信区间：6 - 19%，P < 0.001）。相比之下，随后在34周后分娩的接受产前皮质类固醇的妇女数量持续增加，平均年增长率为21%（95%置信区间：16 - 25%，P < 0.001）。
在我们医院，越来越多在34周后分娩的妇女在34周前接受了产前皮质类固醇。目前尚不清楚这一情况的长期影响。
