Um-Bergström Miranda, Papadogiannakis Nikos, Westgren Magnus, Vinnars Marie-Therese
Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.
Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2018 Jan;97(1):74-81. doi: 10.1111/aogs.13242. Epub 2017 Oct 26.
Mothers at risk of preterm birth are treated with antenatal corticosteroids, which have advantageous effects for prematurely born infants. Accelerated villous maturation in the placenta is also associated with improved perinatal outcome. The primary aim of this study was to examine the association between antenatal corticosteroids and accelerated villous maturation. The secondary aim was to study associations with other placental pathologies.
A retrospective cohort study including 105 women who had (n = 75) or had not (n = 30) been treated with antenatal corticosteroids. The women gave birth between 22 and 26 weeks of gestation in Stockholm County between 1 April 2004 and 31 March 2007. A pathologist blinded to all clinical data except gestational age examined the placental slides to identify pathology parameters. The outcomes were correlated with antenatal corticosteroid treatment, and confounding factors were adjusted using logistic regression.
Accelerated villous maturation was significantly higher in the group treated with corticosteroids (odds ratio 16, 95% CI 2.4-690, p = 0.0005). After adjustment for gestational age and preeclampsia, the difference remained significant (odds ratio 8.9, 95% CI 1.2-389, p = 0.021). No significant associations were found regarding the secondary outcome variables, after adjusting for possible confounders.
Antenatal corticosteroid treatment before preterm birth is associated with accelerated villous maturation. This could be one of the pathways by which corticosteroids are beneficial for preterm infants.
有早产风险的母亲会接受产前皮质类固醇治疗，这对早产婴儿有有利影响。胎盘绒毛加速成熟也与围产期结局改善相关。本研究的主要目的是检查产前皮质类固醇与绒毛加速成熟之间的关联。次要目的是研究与其他胎盘病理的关联。
一项回顾性队列研究，纳入105名接受（n = 75）或未接受（n = 30）产前皮质类固醇治疗的女性。这些女性于2004年4月1日至2007年3月31日在斯德哥尔摩县妊娠22至26周时分娩。一名对除胎龄外的所有临床数据均不知情的病理学家检查胎盘切片以确定病理参数。将结局与产前皮质类固醇治疗进行关联，并使用逻辑回归调整混杂因素。
接受皮质类固醇治疗的组中绒毛加速成熟显著更高（比值比16，95%可信区间2.4 - 690，p = 0.0005）。在调整胎龄和子痫前期后，差异仍然显著（比值比8.9，95%可信区间1.2 - 389，p = 0.021）。在调整可能的混杂因素后，未发现与次要结局变量有显著关联。
早产前的产前皮质类固醇治疗与绒毛加速成熟相关。这可能是皮质类固醇对早产婴儿有益的途径之一。
