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早产及神经保护的作用。

Preterm birth and the role of neuroprotection.

机构信息

Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29492, USA

出版信息

BMJ. 2015 Jan 20;350:g6661. doi: 10.1136/bmj.g6661.

Abstract

Preterm birth remains a common complication of pregnancy and causes substantial neonatal morbidity and mortality. As improvements in the care of preterm neonates have outpaced efforts to prevent preterm birth, the numbers of survivors with neurologic sequelae that affect quality of life have increased. The main strategies to reduce the impact of neurologic complications of prematurity include prevention of preterm birth and protection of the developing fetal brain through antenatal administration of drugs. These strategies rely on a basic understanding of the intertwined pathophysiology of spontaneous preterm labor and perinatal brain injury, which will be reviewed here. The review will outline current methods for the prevention of prematurity and neuroprotection. The use of magnesium sulfate as a neuroprotective compound will be discussed, including concerns over its association with increased pediatric mortality and abnormalities in bone density.

摘要

早产仍然是妊娠的常见并发症,会导致大量新生儿发病和死亡。随着对早产儿护理的改善超过了预防早产的努力,患有影响生活质量的神经后遗症的幸存者人数有所增加。减少早产神经并发症影响的主要策略包括预防早产和通过产前药物治疗来保护发育中的胎儿大脑。这些策略依赖于对自发性早产和围产期脑损伤相互交织的病理生理学的基本理解,这将在本文中进行回顾。本文将概述预防早产和神经保护的当前方法。将讨论硫酸镁作为神经保护化合物的使用,包括对其与儿科死亡率增加和骨密度异常相关的担忧。

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