Wong Tiffany Tuck Chin, Tung Janice Su Zhen, Lau Hester Chang Qi, Tagore Shephali
Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital (KKH), 100 Bukit Timah Road, Singapore, 229899, Singapore.
Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Arch Gynecol Obstet. 2018 Feb;297(2):373-379. doi: 10.1007/s00404-017-4577-4. Epub 2017 Oct 29.
Antenatal corticosteroids before preterm births are considered to be most effective 48 h after and up to 1 week after the first dose. We aim to evaluate: (1) our practice of administration of antenatal corticosteroids in Singapore; (2) admission characteristics of women for discriminatory factors of spontaneous preterm delivery within 1 week.
This is a retrospective study in a tertiary obstetrics unit in Singapore. 3044 women who delivered live births (at term or preterm) from 1st November 2014 to 31st January 2015, who were at risk of spontaneous or induced preterm delivery, were included. Data related to the time of and indications for antenatal corticosteroids administration, characteristics assessed at the time of presentation, and time of delivery were collected and analysed.
85.9% of women who delivered at gestational age ≤ 34 received at least one dose. 22.1% had delivered within the window of efficacy. Gestational age > 32 weeks at presentation, uterine activity on tocography and cervical dilation with effacement were associated with preterm delivery within 1 week of presentation.
Overall, our antenatal corticosteroids administration rate is comparable to that attained by centres in other developed countries. It is difficult but important to discriminate women who will benefit from this timely intervention.
早产前使用产前糖皮质激素被认为在首剂用药后48小时至1周内效果最佳。我们旨在评估：（1）新加坡产前糖皮质激素的使用情况；（2）1周内自然早产鉴别因素的产妇入院特征。
这是一项在新加坡一家三级产科单位进行的回顾性研究。纳入了2014年11月1日至2015年1月31日期间分娩活产（足月或早产）、有自然或引产早产风险的3044名妇女。收集并分析了与产前糖皮质激素给药时间和指征、就诊时评估的特征以及分娩时间相关的数据。
孕周≤34周分娩的妇女中，85.9%至少接受了一剂糖皮质激素。22.1%在疗效窗口期内分娩。就诊时孕周>32周、宫缩图显示子宫活动以及宫颈扩张伴消退与就诊后1周内早产相关。
总体而言，我们的产前糖皮质激素给药率与其他发达国家中心的给药率相当。鉴别哪些妇女将从这种及时干预中获益虽困难但很重要。
