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孕26至34周早产儿产前使用类固醇促进肺成熟与出生后48小时内低血糖之间的关联。

Association between antenatal steroids for lung maturation and hypoglycaemia in the first 48 hours in premature infants between 26 and 34 weeks of gestational age.

作者信息

Valencia Gina, Rojas Victor

机构信息

Pediatric Department, Industrial University of Santander, University Hospital of Santander, Colombia.

出版信息

Pediatr Endocrinol Diabetes Metab. 2019;25(4):177-182. doi: 10.5114/pedm.2019.89639.

Abstract

INTRODUCTION

Hypoglycaemia is frequent in premature infants and can generate neurological alterations. There is controversy concerning exposure to antenatal corticosteroids for pulmonary maturation and hypoglycaemia.

AIM OF THE STUDY

To evaluate whether there is a relationship between neonatal hypoglycaemia and the use of antenatal corticosteroids for lung maturation in preterm infants between 26 and 34 weeks of gestational age, and to correlate this with other variables.

MATERIAL AND METHODS

A prospective closed cohort study in preterm infants between 26 and 34 weeks of gestation, who were born in the University Hospital of Santander (HUS) between 2017 and 2018, divided into two cohorts: exposed and not exposed to antenatal corticosteroids for lung maturation. The data was analysed using Stata 12.0 Software.

RESULTS

Of 173 preterm infants, 152 (87.9%) received lung maturation. There were no significant differences between the maternal characteris-tics of both cohorts. In the neonatal group, sex, gestational age, birth weight, Apgar score, and glucose infusion rate were evaluated without significant differences. The cumulative incidence of hypoglycaemia in the first 48 hours was 28.6% in those not exposed to antenatal corticosteroids and 25.4% among the exposed ones (RR 0.875, IC95% 0.421-1.815), while the incidence density of hypogly-caemia was 8.80 and 6.36 events/1000 person-hours, respectively (HR 0.743 IC95% 0.314-1.759).

CONCLUSIONS

There was no significant difference in the incidence of hypoglycaemia among those exposed and those not exposed to antenatal steroids for lung maturation in this study.

摘要

引言

低血糖在早产儿中很常见,并且可能导致神经功能改变。关于产前使用糖皮质激素促进肺成熟与低血糖之间存在争议。

研究目的

评估胎龄在26至34周的早产儿中,新生儿低血糖与使用产前糖皮质激素促进肺成熟之间是否存在关联,并将其与其他变量进行相关性分析。

材料与方法

对2017年至2018年在桑坦德大学医院(HUS)出生的26至34周胎龄的早产儿进行前瞻性封闭队列研究,分为两组:接受和未接受产前糖皮质激素促进肺成熟的组。使用Stata 12.0软件对数据进行分析。

结果

173例早产儿中,152例(87.9%)接受了肺成熟治疗。两组产妇的特征无显著差异。在新生儿组中,对性别、胎龄、出生体重、阿氏评分和葡萄糖输注速率进行评估,无显著差异。未接受产前糖皮质激素治疗的婴儿在出生后48小时内低血糖的累积发生率为28.6%,接受治疗的婴儿为25.4%(相对危险度0.875,95%置信区间为0.421 - 1.815),而低血糖的发病密度分别为8.80和6.36事件/1000人·小时(风险比0.743,95%置信区间为0.314 - 1.759)。

结论

本研究中,接受和未接受产前糖皮质激素促进肺成熟治疗的婴儿低血糖发生率无显著差异。

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