Ventolini Gary, Neiger Ran, Mathews Lindsey, Adragna Norma, Belcastro Marc
Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, OH 45409, USA.
Am J Perinatol. 2008 Feb;25(2):79-83. doi: 10.1055/s-2007-1022470. Epub 2008 Jan 10.
We studied the effect of antenatal corticosteroids on the incidence of respiratory disorders in singleton neonates born between 34 and 36 weeks of gestation. Retrospective analysis was conducted of the incidence of respiratory distress syndrome (RDS) and other respiratory disorders (need for mechanical ventilation, continuous positive airway pressure, and prolonged oxygen therapy) among singleton neonates delivered between 34 and 36 weeks of gestation who were exposed to antenatal corticosteroids, compared with neonates who were not exposed. Statistical analyses included two-tailed T tests, two-way analysis of variance for continuous data, and chi-square analysis for ratios. A probability of 0.05 was considered significant. Between January 1, 2000, and December 31, 2004, 1078 neonates were born between 34 and 36 weeks of gestation. Information regarding antenatal corticosteroids was available in 1044: 574 neonates (53.2%) were exposed to antenatal corticosteroids and 470 (43.6%) were not. One thousand and eighteen neonates were admitted to the neonatal intensive care unit. Respiratory disorders were diagnosed in 140 of those exposed to antenatal steroids (24.4%) and in 382 of the nonexposed (81.3%) ( P < 0.0001). Two hundred and ten neonates (20.6%) developed RDS: Of those, 43 were exposed to antenatal corticosteroids and 167 were not (incidence of RDS was 7.5% and 35.5%, respectively; P = 0.0001). The beneficial effects of corticosteroids were similar in both genders. It appears that the exposure of singleton pregnancies to antenatal corticosteroids between 24 and 34 weeks of gestation is associated with a significantly lower incidence of respiratory disorders among neonates born at 34 to 36 weeks of gestation. Further studies are needed to determine whether administering antenatal steroids to women experiencing preterm labor after 34 weeks of gestation would be associated with a similar beneficial effect.
我们研究了产前使用皮质类固醇对妊娠34至36周出生的单胎新生儿呼吸系统疾病发病率的影响。对妊娠34至36周出生且暴露于产前皮质类固醇的单胎新生儿与未暴露的新生儿相比,进行了呼吸窘迫综合征(RDS)及其他呼吸系统疾病(机械通气需求、持续气道正压通气、延长氧疗)发病率的回顾性分析。统计分析包括双尾T检验、连续数据的双向方差分析以及比率的卡方分析。概率为0.05被视为具有显著性。在2000年1月1日至2004年12月31日期间,有1078例新生儿在妊娠34至36周出生。其中1044例有产前皮质类固醇使用信息:574例新生儿(53.2%)暴露于产前皮质类固醇,470例(43.6%)未暴露。1018例新生儿入住新生儿重症监护病房。暴露于产前类固醇的新生儿中有140例(24.4%)被诊断患有呼吸系统疾病,未暴露的新生儿中有382例(81.3%)(P<0.0001)。210例新生儿(20.6%)发生RDS:其中43例暴露于产前皮质类固醇,167例未暴露(RDS发病率分别为7.5%和35.5%;P = 0.0001)。皮质类固醇对男女的有益作用相似。看来,妊娠24至34周期间单胎妊娠暴露于产前皮质类固醇与妊娠34至36周出生的新生儿呼吸系统疾病发病率显著降低有关。需要进一步研究以确定在妊娠34周后早产的妇女中使用产前类固醇是否会有类似的有益效果。