Al Riyami Nihal, Al Hadhrami Abeer, Al Lawati Tuqa, Pillai Silja, Abdellatif Mohamed, Jaju Sanjay
Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Muscat, Oman.
Obstetrics and Gynecology Residency Training Program, Oman Medical Specialty Board, Muscat, Oman.
Oman Med J. 2020 Jun 25;2020(35):e133. doi: 10.5001/omj.2020.51. eCollection 2020 May.
We sought to assess the relationship between respiratory distress syndrome (RDS) in neonates delivered by elective cesarean section at term gestation with and without corticosteroids cover. We also aimed to determine other neonatal complications such as sepsis, hypoglycemia, and hyperbilirubinemia.
We conducted a retrospective descriptive study from January 2010 to December 2015 on all Omani women who delivered by elective cesarean section at Sultan Qaboos University Hospital between 37+0 and 38+6 weeks gestation.
Among 650 patients included in the study, 20.8% (n = 135) received corticosteroids antenatally and 79.2% did not. RDS was found in 16 out of 650 neonates, making the prevalence of RDS 2.5%. Higher gravidity and parity and a mean gestational age of less than 37.6 weeks, were associated with a significant risk of RDS. Administration of antenatal corticosteroids did not change the respiratory morbidity in the newborns ( = 0.340). A mean birth weight of 2.9 kg was associated with a significant risk of RDS ( = 0.043). All 16 newborns required neonatal intensive care unit admission and ventilator support. The most common ventilatory support used was continuous positive airway pressure (56.2%). The most common secondary complication in neonates diagnosed with RDS was transient tachypnea of the newborn (53.8%).
The prevalence of RDS was low. Giving antenatal corticosteroids for patients with planned elective cesarean at term did not seem to have a beneficial effect on neonatal respiratory morbidity. Further studies with larger sample size including multiple centers is recommended.
我们试图评估足月妊娠时接受选择性剖宫产且有或无糖皮质激素覆盖的新生儿呼吸窘迫综合征（RDS）之间的关系。我们还旨在确定其他新生儿并发症，如败血症、低血糖和高胆红素血症。
我们对2010年1月至2015年12月期间在苏丹卡布斯大学医院接受37⁺⁰至38⁺⁶周妊娠选择性剖宫产的所有阿曼妇女进行了一项回顾性描述性研究。
在纳入研究的650例患者中，20.8%（n = 135）在产前接受了糖皮质激素治疗，79.2%未接受。650例新生儿中有16例发生RDS，RDS患病率为2.5%。较高的孕次和产次以及平均胎龄小于37.6周与RDS的显著风险相关。产前给予糖皮质激素并未改变新生儿的呼吸发病率（P = 0.340）。平均出生体重2.9 kg与RDS的显著风险相关（P = 0.043）。所有16例新生儿均需入住新生儿重症监护病房并接受呼吸机支持。最常用的通气支持是持续气道正压通气（56.2%）。诊断为RDS的新生儿最常见的次要并发症是新生儿短暂性呼吸急促（53.8%）。
RDS的患病率较低。对足月计划选择性剖宫产的患者给予产前糖皮质激素似乎对新生儿呼吸发病率没有有益影响。建议进行包括多个中心的更大样本量的进一步研究。
