晚期早产儿产前皮质激素治疗后发生新生儿低血糖症。
Neonatal hypoglycemia after initiation of late preterm antenatal corticosteroids.
机构信息
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Division of Neonatology, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
出版信息
J Perinatol. 2020 Sep;40(9):1339-1348. doi: 10.1038/s41372-020-0589-1. Epub 2020 Feb 14.
OBJECTIVE
To compare the frequency and severity of neonatal hypoglycemia in pregnancies treated with and without late preterm antenatal corticosteroids.
STUDY DESIGN
We conducted a retrospective cohort study of late preterm deliveries at LAC + USC (2015-2018). Neonatal outcomes were compared between pregnancies treated with and without corticosteroids.
RESULTS
93 pregnancies (39.9%) received corticosteroids and 140 (60.1%) did not. Neonates born to women given corticosteroids were more likely to be hypoglycemic (47.3 vs. 29.3%, OR 2.25, p = 0.01). The mean initial glucose (45.6 mg/dL vs. 51.9 mg/dL, p = 0.01) and glucose nadir (39.1 mg/dL vs. 45.4 mg/dL, p < 0.001) were significantly lower if the neonates received corticosteroids. Neonates admitted to the NICU solely for hypoglycemia were more likely to be born to women treated with corticosteroids (OR 4.71, p = 0.01).
CONCLUSION
Administration of late preterm corticosteroids was associated with an increased incidence and severity of neonatal hypoglycemia.
目的
比较接受和未接受晚期早产儿产前皮质类固醇治疗的妊娠中新生儿低血糖的发生频率和严重程度。
研究设计
我们对 LAC + USC（2015-2018 年）的晚期早产儿分娩进行了回顾性队列研究。比较了接受皮质类固醇治疗和未接受皮质类固醇治疗的妊娠中的新生儿结局。
结果
93 例（39.9%）妊娠接受皮质类固醇治疗，140 例（60.1%）未接受皮质类固醇治疗。接受皮质类固醇治疗的女性所生的新生儿更有可能发生低血糖（47.3%比 29.3%，OR 2.25，p=0.01）。如果新生儿接受皮质类固醇治疗，其初始血糖平均值（45.6mg/dL 比 51.9mg/dL，p=0.01）和血糖最低点（39.1mg/dL 比 45.4mg/dL，p<0.001）显著降低。因低血糖而仅被收入新生儿重症监护病房（NICU）的新生儿更有可能出生于接受皮质类固醇治疗的女性（OR 4.71，p=0.01）。
结论
晚期早产儿皮质类固醇的应用与新生儿低血糖的发生率和严重程度增加有关。
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