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评估产前倍他米松对晚期早产儿(34-37 周)新生儿呼吸疾病的影响。

Evaluation of the effect of antenatal betamethasone on neonatal respiratory morbidities in late preterm deliveries (34-37 weeks).

机构信息

Department of Perinatology, Mahdieh Hospital, Beheshti University of Medical Sciences, Tehran, Iran.

Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Matern Fetal Neonatal Med. 2020 Aug;33(15):2533-2540. doi: 10.1080/14767058.2018.1554051. Epub 2019 Jan 7.

Abstract

Since late preterm neonates (34-36 weeks) are more at risk of respiratory morbidities, the present study was conducted to evaluate the effect of antenatal betamethasone on neonatal respiratory morbidities in women with late preterm delivery. This randomized clinical trial was performed on 240 women with single pregnancy that was at high risk of late preterm delivery (34-37 weeks). The patients were randomly assigned to either betamethasone (intramuscular injection of 12 mg of betamethasone in two doses with an interval of 24 hours) or the control group. The two groups were compared with each other in terms of respiratory morbidities, NICU admission and its cause and duration, hospitalization in the neonatal ward for more than 6 hours, and the duration of hospitalization. Of all, 79 neonates (33%) had one or more respiratory morbidities. The observed morbidities in the betamethasone group were significantly less prevalent than those in the control group (19 neonates (16%) and 60 neonates (50%), respectively,  < .001). The most frequently observed respiratory morbidity was needed for oxygen for more than an hour (34 infants, 14%). The need for oxygen for more than an hour, the need for continuous positive airway pressure (CPAP), respiratory distress syndrome (RDS), and the need for surfactant were significantly less observed in betamethasone group than in the control group. A total of 43 neonates (18%) were admitted to NICU and then hospitalized in the neonatal ward; the number of admitted neonates were significantly lower in the betamethasone group than in the control group (11 neonates (9%) and 32 neonates (27%), respectively,  < .001). Moreover, 15 neonates (6%) were admitted to the neonatal ward and there were no significant differences between the betamethasone and control groups (10 neonates (8%) and 5 neonates (4%), respectively,  = .182). Totally, 58 neonates (24%) were hospitalized; the number of hospitalized neonates was significantly lower in the betamethasone group than in the control group (21 neonates (18%) and 37 neonates (31%), respectively,  = .016). The results of this study showed that the antenatal administration of betamethasone in late preterm delivery (34-37 weeks) can improve respiratory morbidities and decrease the frequency of NICU admission.

摘要

本研究旨在评估产前倍他米松对晚期早产儿(34-36 周)呼吸疾病的影响,因此进行了这项随机临床试验。该试验纳入了 240 例有晚期早产(34-37 周)高危因素的单胎妊娠妇女。患者随机分为倍他米松组(肌内注射 12mg 倍他米松,每 24 小时 1 次,2 剂)或对照组。比较两组呼吸疾病、NICU 入院及其原因和时间、新生儿病房住院时间超过 6 小时、住院时间。共有 79 例(33%)新生儿有 1 种或多种呼吸疾病。倍他米松组观察到的疾病明显少于对照组(19 例(16%)和 60 例(50%),<0.001)。最常见的呼吸疾病是需要吸氧 1 小时以上(34 例,14%)。需要吸氧 1 小时以上、持续气道正压通气(CPAP)、呼吸窘迫综合征(RDS)和需要表面活性剂的新生儿,在倍他米松组明显少于对照组。共有 43 例(18%)新生儿入住 NICU,然后转入新生儿病房;倍他米松组入住 NICU 的新生儿明显少于对照组(11 例(9%)和 32 例(27%),<0.001)。此外,15 例(6%)新生儿入住新生儿病房,倍他米松组和对照组之间无差异(10 例(8%)和 5 例(4%),=0.182)。共有 58 例(24%)新生儿住院;倍他米松组住院的新生儿明显少于对照组(21 例(18%)和 37 例(31%),=0.016)。本研究结果表明,产前给予倍他米松治疗晚期早产儿(34-37 周)可改善呼吸疾病,降低 NICU 入院率。

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