School of Pharmacy, Catholic University of Health and Allied Sciences, Bugando Area, PO Box 1464, Mwanza, Tanzania.
World J Pediatr. 2021 Apr;17(2):131-140. doi: 10.1007/s12519-020-00398-6. Epub 2021 Jan 3.
The most common cause of death among preterm infants in low- and middle-income countries is respiratory distress syndrome. The purpose of this review was to assess whether antenatal corticosteroids given to women at risk of preterm birth at ≤ 34 weeks of gestation reduce rates of neonatal mortality and respiratory distress syndrome in low- and middle-income countries.
Two reviewers independently searched four databases including MEDLINE (through PubMed), CINAHL, Embase, and Cochrane Libraries. We did not apply any language or date restrictions. All publications up to April 2020 were included in this search.
The search yielded 71 articles, 10 of which were included in this review (3 randomized controlled trials, 7 observational studies, 36,773 neonates). The majority of studies reported associations between exposure to antenatal corticosteroids and lower rates of neonatal mortality and respiratory distress syndrome. However, a few studies reported that antenatal corticosteroids were not associated with improved preterm birth outcomes.
Most of the studies in low- and middle-income countries showed that use of antenatal corticosteroids in hospitals with high levels of neonatal care was associated with lower rates of neonatal mortality and respiratory distress syndrome. However, the findings are inconclusive because some studies in low-resource settings reported that antenatal corticosteroids had no benefit in reducing rates of neonatal mortality or respiratory distress syndrome. Further research on the impact of antenatal corticosteroids in resource-limited settings in low-income countries is a priority.
在中低收入国家，早产儿死亡的最常见原因是呼吸窘迫综合征。本综述旨在评估在妊娠 34 周之前有早产风险的女性接受产前皮质激素治疗是否能降低中低收入国家新生儿死亡率和呼吸窘迫综合征的发生率。
两位审查员独立检索了四个数据库，包括 MEDLINE（通过 PubMed）、CINAHL、Embase 和 Cochrane 图书馆。我们没有对语言或日期进行任何限制。这项搜索收录了截至 2020 年 4 月的所有出版物。
搜索结果得到了 71 篇文章，其中 10 篇被纳入本综述（3 项随机对照试验，7 项观察性研究，36773 例新生儿）。大多数研究报告了暴露于产前皮质激素与较低的新生儿死亡率和呼吸窘迫综合征发生率之间的关联。然而，一些研究报告称产前皮质激素与改善早产结局无关。
大多数来自中低收入国家的研究表明，在新生儿护理水平较高的医院中使用产前皮质激素与较低的新生儿死亡率和呼吸窘迫综合征发生率相关。然而，由于一些资源有限的研究报告称产前皮质激素在降低新生儿死亡率或呼吸窘迫综合征发生率方面没有益处，因此结果并不确定。进一步研究产前皮质激素在资源有限的中低收入国家的影响是当务之急。
