Department of Obstetrics and Gynecology, Columbia University, New York, New York 10032, USA.
Obstet Gynecol. 2012 Mar;119(3):555-9. doi: 10.1097/AOG.0b013e31824758f6.
To evaluate whether neonates born to women who previously had received antenatal corticosteroids and then delivered a late-preterm-birth neonate had less respiratory morbidity compared with those not exposed to antenatal corticosteroids.
This is a secondary analysis from a multicenter observational study regarding mode of delivery after previous cesarean delivery. We compared women who received one course of antenatal corticosteroids with unexposed parturients and evaluated various respiratory outcomes among those having a singleton, late-preterm-birth neonate. We controlled for potential confounders including gestational age at delivery, diabetes, mode of delivery, and maternal race.
Five thousand nine hundred twenty-four patients met the inclusion criteria; 550 received steroids and 5,374 did not. In the univariable model, compared with unexposed women, those who received antenatal corticosteroids appeared more likely to have neonates who required ventilatory support (11.5% compared with 8.6%, P=.022), had respiratory distress syndrome (RDS) (17.1% compared with 12.2%, P=.001), developed transient tachypnea of the newborn (12.9% compared with 9.8%, P=.020), or required resuscitation in the delivery room (55.8% compared with 49.7%, P=.007). After controlling for confounding factors, we found no significant differences among the groups regarding all of the above outcomes with an odds ratio for RDS of 0.78 (95% confidence interval, 0.60-1.02) and ventilator support of 0.75 (95% confidence interval, 0.55-1.03).
Exposure to antenatal corticosteroids does not significantly affect respiratory outcomes among those with a subsequent late-preterm birth.
评估先前接受过产前皮质类固醇治疗而后分娩晚期早产儿的女性所生新生儿的呼吸道发病率是否低于未接受产前皮质类固醇治疗的新生儿。
这是一项关于既往剖宫产分娩后分娩方式的多中心观察性研究的二次分析。我们比较了接受过 1 疗程产前皮质类固醇治疗的女性与未暴露于分娩的产妇，并评估了具有单胎晚期早产儿的产妇中各种呼吸道结局。我们控制了潜在的混杂因素，包括分娩时的胎龄、糖尿病、分娩方式和产妇种族。
符合纳入标准的患者有 5924 例；其中 550 例接受了类固醇治疗，5374 例未接受治疗。在单变量模型中，与未暴露于分娩的女性相比，接受产前皮质类固醇治疗的女性其需要通气支持的新生儿比例更高（11.5%比 8.6%，P=.022），患有呼吸窘迫综合征（RDS）的新生儿比例更高（17.1%比 12.2%，P=.001），患有新生儿暂时性呼吸急促的新生儿比例更高（12.9%比 9.8%，P=.020），或需要在产房复苏的新生儿比例更高（55.8%比 49.7%，P=.007）。在控制混杂因素后，我们发现各组之间在所有上述结局方面均无显著差异，RDS 的比值比为 0.78（95%可信区间，0.60-1.02），通气支持的比值比为 0.75（95%可信区间，0.55-1.03）。
暴露于产前皮质类固醇并不会显著影响随后的晚期早产儿的呼吸道结局。
