产前皮质类固醇用于极早产儿分娩。
Antenatal corticosteroids for periviable birth.
机构信息
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, 622 W. 168th St, New York, NY 10032.
出版信息
Semin Perinatol. 2013 Dec;37(6):410-3. doi: 10.1053/j.semperi.2013.06.024.
Abstract
Antenatal corticosteroids have been proven to accelerate fetal lung development and reduce neonatal morbidity and mortality when given between 28 and 34 weeks of gestation. However, there is only limited research to guide their use in the periviable period (22-26 weeks). Laboratory studies suggest that it is biologically plausible for antenatal steroids to be effective in this gestational period. In addition, cohort studies have demonstrated the efficacy of antenatal corticosteroids in reducing neonatal mortality and IVH. Follow-up studies performed between 18 and 22 months of age also suggest a long-term benefit to antenatal use in this period. Based on this information, antenatal corticosteroids should be used in appropriate patients at high risk for preterm birth at 23-26 weeks of gestation. An advantageous outcome to treatment at 22 weeks is less certain.
摘要
产前皮质类固醇已被证明可加速胎儿肺发育，并降低 28 至 34 孕周之间新生儿的发病率和死亡率。然而，只有有限的研究可以指导它们在极早产儿期（22-26 周）使用。实验室研究表明，产前类固醇在这一孕龄期有效是具有生物学合理性的。此外，队列研究也表明产前皮质类固醇在降低新生儿死亡率和 IVH 方面是有效的。在 18 至 22 个月龄进行的随访研究也表明，在此期间产前使用皮质类固醇有长期获益。基于这些信息，对于 23-26 孕周有早产高风险的患者，应使用产前皮质类固醇。在 22 周进行治疗的有利结局则不太确定。
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