Department of Obstetrics and Gynecology at Columbia University, New York, NY, USA.
Am J Obstet Gynecol. 2010 Sep;203(3):219.e1-5. doi: 10.1016/j.ajog.2010.04.047. Epub 2010 Jul 1.
Antenatal corticosteroids (ACS) decrease respiratory distress syndrome in singleton gestations. Twin data are less clear. Obesity and body mass index (BMI) also affect medication distribution volume. We evaluated whether maternal or neonatal cord betamethasone concentrations differed in twin gestations or obese patients.
Participants receiving betamethasone in a randomized controlled trial of weekly ACS were identified. We analyzed maternal delivery and cord serum betamethasone concentrations comparing singletons with twins and obese (BMI > or =30 kg/m(2)) with nonobese women.
Fifty-five maternal and 45 cord blood samples were available. Unadjusted median maternal serum concentrations appeared paradoxically higher in both twin gestations and the obese. However, after controlling for confounders, there were no differences in betamethasone concentrations in maternal serum or cord blood between singletons and twins (P = .61 vs P = .14) or nonobese and obese women (P = .67 vs .12).
Maternal and umbilical cord blood serum betamethasone concentrations are not different in twin gestations or obese women.
产前皮质激素(ACS)可降低单胎妊娠的呼吸窘迫综合征。双胞胎的数据则不太清楚。肥胖和体重指数(BMI)也会影响药物分布容积。我们评估了双胞胎妊娠或肥胖患者的母体或新生儿脐带倍他米松浓度是否存在差异。
鉴定了在每周 ACS 的随机对照试验中接受倍他米松治疗的参与者。我们分析了比较单胎与双胞胎以及肥胖(BMI>或=30 kg/m2)与非肥胖女性的母体分娩和脐带血清倍他米松浓度。
有 55 份母体和 45 份脐带血样本可用。未经调整的中位数母体血清浓度在双胞胎妊娠和肥胖中似乎呈反常升高。然而,在控制混杂因素后,母体血清或脐带血中的倍他米松浓度在单胎与双胞胎(P=0.61 与 P=0.14)或非肥胖与肥胖妇女之间无差异(P=0.67 与 P=0.12)。
双胞胎妊娠或肥胖妇女的母体和脐带血清倍他米松浓度没有差异。