Battin Malcolm R, Bevan Coila, Harding Jane E
Department of Paediatrics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Am J Obstet Gynecol. 2007 Jul;197(1):40.e1-6. doi: 10.1016/j.ajog.2007.02.015.
This study was undertaken to compare the effects of exposure to repeated courses of antenatal steroids with those of a single course on hypothalamic-pituitary-adrenal axis function.
Women at risk of premature delivery were assessed for entry into a randomized controlled trial of repeated courses of corticosteroids (ACTORDS). If a woman declined the randomized trial then consent was sought for collection of observational data. Baseline bloods for cortisol and adrenocorticotropic hormone levels were collected and in a subset of infants a metyrapone test performed.
In the 86 studied infants, cortisol and adrenocorticotropic hormone levels did not differ between those exposed to single and repeated courses of antenatal steroids (P = .53 and P = .15, respectively). Although cortisol levels fell in response to metyrapone (P = .03) this response was not different between the single and repeated course groups (P = .46).
Repeated courses of antenatal steroids do not cause important hypothalamic-pituitary-adrenal axis suppression in the neonate.
本研究旨在比较多次产前使用类固醇与单次使用对下丘脑 - 垂体 - 肾上腺轴功能的影响。
对有早产风险的女性进行评估，以纳入一项关于多次使用皮质类固醇的随机对照试验（ACTORDS）。如果女性拒绝参与随机试验，则寻求其同意收集观察数据。收集皮质醇和促肾上腺皮质激素水平的基线血液样本，并在一部分婴儿中进行甲吡酮试验。
在86名研究婴儿中，单次和多次产前使用类固醇的婴儿的皮质醇和促肾上腺皮质激素水平无差异（分别为P = 0.53和P = 0.15）。尽管甲吡酮使皮质醇水平下降（P = 0.03），但单次和多次用药组之间的这种反应无差异（P = 0.46）。
多次产前使用类固醇不会对新生儿下丘脑 - 垂体 - 肾上腺轴造成显著抑制。
