Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey.
Am J Perinatol. 2022 Sep;39(12):1334-1340. doi: 10.1055/s-0040-1722330. Epub 2021 Jan 6.
The aim of this study was to identify the effects of antenatal steroids (ANS) on acute kidney injury (AKI) in very low birth weight (VLBW) preterm infants.
We performed a retrospective cohort study of VLBW infants admitted to a tertiary-care neonatal intensive care unit between January 2016 and June 2019. Infants were divided into no ANS, partial ANS, and complete ANS groups. Serum creatinine (SCr) levels and rates of AKI during the first 2 weeks of life were compared.
During the study period, 335 infants met our inclusion criteria. Among no, partial, and complete ANS groups, there were significant differences in rates of stages 2 and 3 AKI (17, 11, and 6%, respectively). Logistic regression analysis revealed that complete ANS course was associated with lower rates of AKI (odds ratio [OR] = 0.41 95% confidence interval [CI]: 0.20-0.83) and stages 2 and 3 AKI (OR = 0.205 95% CI: 0.075-0.563) compared with no ANS. Infants in complete ANS group had significantly lower SCr at 72 hours of life and at discharge, SCr peak was compared with infants in no ANS group.
In VLBW infants, complete ANS exposure may be associated with improved renal function and decreased risk for AKI compared with no ANS.
· The effects of antenatal steroid treatment on renal function in preterm infants are not clear.. · A complete course of antenatal steroid decreases the risk for acute kidney injury in preterm infants.. · Infants who are not exposed to antenatal steroids need closer observation of their renal function..
本研究旨在探讨产前类固醇（ANS）对极低出生体重（VLBW）早产儿急性肾损伤（AKI）的影响。
我们对 2016 年 1 月至 2019 年 6 月期间在一家三级新生儿重症监护病房住院的 VLBW 婴儿进行了回顾性队列研究。将婴儿分为无 ANS、部分 ANS 和完全 ANS 组。比较了出生后前 2 周内的血清肌酐（SCr）水平和 AKI 发生率。
在研究期间，有 335 名婴儿符合纳入标准。在无 ANS、部分 ANS 和完全 ANS 组中，AKI 第 2 期和第 3 期的发生率存在显著差异（分别为 17%、11%和 6%）。Logistic 回归分析显示，与无 ANS 相比，完全 ANS 疗程与 AKI 发生率较低（比值比[OR] = 0.41，95%置信区间[CI]：0.20-0.83）和第 2 期和第 3 期 AKI（OR = 0.205，95%CI：0.075-0.563）相关。与无 ANS 组相比，完全 ANS 组婴儿在出生后 72 小时和出院时的 SCr 明显较低，SCr 峰值也较低。
在 VLBW 婴儿中，与无 ANS 相比，完全 ANS 暴露可能与肾功能改善和 AKI 风险降低相关。
·产前类固醇治疗对早产儿肾功能的影响尚不清楚。·完全疗程的产前类固醇可降低早产儿急性肾损伤的风险。·未接受产前类固醇治疗的婴儿需要更密切地观察其肾功能。
