Newborn Services, Auckland City Hospital, Auckland, New Zealand.
Arch Dis Child Fetal Neonatal Ed. 2012 Mar;97(2):F99-105. doi: 10.1136/adc.2011.211318. Epub 2011 Jul 27.
To determine the effect of repeated antenatal corticosteroids on postnatal changes in weight, linear growth and head circumference.
Mothers who entered the repeated dose of antenatal steroids (ACTORDS) trial were randomised to additional weekly steroid or placebo. Infant occipital-frontal head circumference, weight and crown-heel length were measured at birth and weekly for 4 weeks or until discharge, whichever was later. Lower leg length was measured using a knemometer daily for the first week, then thrice weekly.
Of 145 babies studied (77.5% of the ACTORDS study infants from this centre), 70 were exposed to repeated antenatal steroids and 75 to placebo. There were no significant differences in prerandomisation demographic and pregnancy data. The mean gestational age at ACTORDS entry was 28.7 weeks and at birth was 31.4 weeks. The mean birth weight was 1618 g. There were no significant differences in postmenstrual age, weight, length or head circumference, nor in z-scores for these measurements, at birth, 4 weeks or discharge. In the first 2 weeks after birth, babies in both groups showed a decrease in z-scores for weight and length. After week 2, growth improved in both groups but babies exposed to repeat antenatal corticosteroids grew more rapidly, as measured by weight gain, increasing head circumference and increasing lower leg length knemometry. This rapid growth was most apparent around weeks 3-5 after birth.
Babies exposed to weekly doses of repeat antenatal corticosteroids demonstrate postnatal growth acceleration 3-5 weeks after birth.
确定重复产前皮质类固醇对出生后体重、线性生长和头围变化的影响。
进入重复剂量产前类固醇（ACTORDS）试验的母亲被随机分配接受额外的每周皮质类固醇或安慰剂。在出生时和出生后每周测量婴儿枕额头围、体重和头臀长，直至 4 周后或出院，以较晚者为准。在第一周每天使用测径器测量小腿长度，然后每周测量三次。
在 145 名研究婴儿中（该中心 ACTORDS 研究婴儿的 77.5%），70 名暴露于重复产前皮质类固醇，75 名暴露于安慰剂。在随机分组前的人口统计学和妊娠数据方面没有显著差异。进入 ACTORDS 的平均胎龄为 28.7 周，出生时为 31.4 周。平均出生体重为 1618 克。在出生时、4 周时或出院时，胎龄、体重、长度或头围，以及这些测量的 z 分数均无显著差异。在出生后的前 2 周，两组婴儿的体重和长度 z 分数均下降。第 2 周后，两组的生长均有所改善，但接受重复产前皮质类固醇的婴儿生长更快，表现为体重增加、头围增加和小腿长度测径器增加。这种快速生长在出生后 3-5 周最为明显。
接受每周重复产前皮质类固醇剂量的婴儿在出生后 3-5 周表现出生后生长加速。
