Christiaens G C, Nieuwenhuis H K, von dem Borne A E, Ouwehand W H, Helmerhorst F M, van Dalen C M, van der Tweel I
Department of Obstetrics and Gynaecology, University Hospital Utrecht, the Netherlands.
Br J Obstet Gynaecol. 1990 Oct;97(10):893-8. doi: 10.1111/j.1471-0528.1990.tb02443.x.
To determine the efficacy of antenatal low dose oral betamethasone in preventing neonatal thrombocytopenia and/or bleeding in infants of mothers with idiopathic thrombocytopenic purpura (ITP).
Hospital department of obstetrics and gynaecology, referral centre.
41 pregnancies in 38 women were randomized. The results of 13 pregnancies were considered non-assessable. The final analysis involved 14 in the betamethasone group and 14 in the non-treatment group. All fulfilled the criteria for ITP.
The treated group received 1.5 mg betamethasone orally per day, from day 259 till day 273 and 1 mg from day 273 till delivery.
Effects of treatment were assessed in terms of maternal platelet counts after the first trimester and neonatal platelet counts at birth and the first week of life and neonatal bleeding episodes.
There were no significant differences in neonatal platelet counts at birth. Two infants in the betamethasone group and one in the untreated group had a severe thrombocytopenia either at birth or during the first week of life (less than 50 x 10(9)/l). Seven infants in the betamethasone group and six in the non-treatment group had a mild thrombocytopenia. The overall frequency of neonatal thrombocytopenia was similar: 64% in the betamethasone group and 57% in the untreated group (95% CI of the true difference: -43.5% to +29.5%). There was also no significant difference in neonatal bleeding episodes.
Low-dose betamethasone in pregnant women with ITP does not prevent thrombocytopenia or bleeding in their newborn infants.
确定产前小剂量口服倍他米松对预防特发性血小板减少性紫癜（ITP）母亲所生婴儿的新生儿血小板减少症和/或出血的疗效。
医院妇产科、转诊中心。
38名女性的41次妊娠被随机分组。13次妊娠的结果被认为不可评估。最终分析涉及倍他米松组14例和非治疗组14例。所有患者均符合ITP标准。
治疗组从妊娠第259天至第273天每天口服1.5毫克倍他米松，从第273天至分娩每天口服1毫克。
根据孕早期后母亲血小板计数、出生时及出生后第一周新生儿血小板计数以及新生儿出血事件评估治疗效果。
出生时新生儿血小板计数无显著差异。倍他米松组有2名婴儿和未治疗组有1名婴儿在出生时或出生后第一周出现严重血小板减少症（低于50×10⁹/L）。倍他米松组有7名婴儿和非治疗组有6名婴儿出现轻度血小板减少症。新生儿血小板减少症的总体发生率相似：倍他米松组为64%，未治疗组为57%（真实差异的95%可信区间：-43.5%至+29.5%）。新生儿出血事件也无显著差异。
ITP孕妇使用小剂量倍他米松不能预防其新生儿的血小板减少症或出血。
