Rasool Ahsan, Farooq Umer, Nazir Qurat-Ul-Ann, Durani Hira Bahar
Department of Anaesthesia, Ayub Medical College, Abbottabad, Pakistan.
Community Medicine,Ayub Medical College, Abbottabad, Pakistan.
J Ayub Med Coll Abbottabad. 2017 Jul-Sep;29(3):393-397.
Dexamethasone is widely used for prevention of respiratory distress syndrome (RDS), necrotising enterocolitis (NEC) and intra-ventricular haemorrhage (IVH) in preterm babies; decreasing the neonatal mortality rate. There is no consensus on the dose of corticosteroid administered to the mother expected to have a preterm baby. This study is conducted to compare the effectiveness of two popular regimens of dexamethasone administration in decreasing incidence of RDS, necrotizing enterocolitis, IVH and neonatal mortality rate.
Randomized control trial was conducted at Ayub Teaching Hospital, Abbottabad from 1st to 31st August, 2014. Sample size was set at 50. Block randomization was employed in the trial to allocate the patients into corresponding groups 'A' and 'B'. Group A was administered 6mg dexamethasone in 4 doses 12 hours apart and group B was administered 2 doses 12 hours apart.
Forty-eight patients participated in the study with 24 patients in each group. Mean age and period gestation of participants were 28.4 years±4.3 SD and 34 weeks±1.9 SD respectively. Four patients in group A gave birth to neonate with RDS compared to two cases in group B. Group B had higher incidence of necrotizing enterocolitis and neonatal mortalities. However, none of these differences observed were statistically significant. No case of IVH was reported in either of the groups..
Both the popular regimens of dexamethasone administration are equally effective in decreasing the incidence of neonatal diseases.
地塞米松广泛用于预防早产儿呼吸窘迫综合征（RDS）、坏死性小肠结肠炎（NEC）和脑室内出血（IVH）；降低新生儿死亡率。对于预期早产的母亲使用皮质类固醇的剂量尚无共识。本研究旨在比较两种常用地塞米松给药方案在降低RDS、坏死性小肠结肠炎、IVH发病率及新生儿死亡率方面的有效性。
2014年8月1日至31日在阿伯塔巴德阿尤布教学医院进行随机对照试验。样本量设定为50。试验采用区组随机化将患者分配到相应的“A”组和“B”组。A组每12小时分4次给予6mg地塞米松，B组每12小时分2次给药。
48例患者参与研究，每组24例。参与者的平均年龄和孕周分别为28.4岁±4.3标准差和34周±1.9标准差。A组有4例患者分娩出患有RDS的新生儿，而B组为2例。B组坏死性小肠结肠炎和新生儿死亡率的发生率较高。然而，观察到的这些差异均无统计学意义。两组均未报告IVH病例。
两种常用的地塞米松给药方案在降低新生儿疾病发病率方面同样有效。
