Research Department of Neonatology, Elizabeth Garrett Anderson Institute for Women's Health, University College London, 2nd floor, Medical School Building, 74 Huntley Street, London, WC1E 6AU, UK.
INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Hôpital Tenon, Rue de la Chine, 75020, Paris, France.
Sci Rep. 2021 Jan 11;11(1):288. doi: 10.1038/s41598-020-79445-1.
Delivery at extreme preterm gestational ages (GA) [Formula: see text] weeks is challenging with limited evidence often focused only on neonatal outcomes. We reviewed management and short term maternal, fetal and neonatal outcomes of births for 132 women (22 + 0 to 26 + 6 weeks' GA) with a live fetus at admission to hospital and in labour or at planned emergency Caesarean section: 103 singleton and 29 (53 live fetuses) twin gestations. Thirty women (23%) had pre-existing medical problems, 110 (83%) had antenatal complications; only 17 (13%) women experienced neither. Major maternal labour and delivery complications affected 35 women (27%). 151 fetuses (97%) were exposed to antenatal steroids, 24 (15%) to tocolysis and 70 (45%) to magnesium sulphate. Delivery complications affected 11 fetuses, with 12 labour or delivery room deaths; survival to discharge was 75% (117/156), increasing with GA: 25% (1/4), 75% (18/24), 69% (29/42), 73% (33/45) and 88% (36/41) at 22, 23, 24, 25 and 26 weeks GA respectively (p = 0.024). No statistically important impact was seen from twin status, maternal illness or obstetric management. Even in a specialist perinatal unit antenatal and postnatal maternal complications are common in extreme preterm births, emphasising the need to include maternal as well as neonatal outcomes.
极早产（GA）[公式：见正文]周的分娩极具挑战性，证据有限，通常仅关注新生儿结局。我们回顾了在医院待产、临产或计划行紧急剖宫产的 132 名活胎产妇（22+0 至 26+6 周 GA）的管理及母婴、胎儿和新生儿短期结局：103 名单胎和 29 名（53 名活胎）双胎妊娠。30 名产妇（23%）有既往内科问题，110 名（83%）有产前并发症；仅 17 名（13%）产妇无上述情况。主要的母胎分娩并发症影响了 35 名产妇（27%）。151 名胎儿（97%）接受了产前皮质激素治疗，24 名（15%）接受了宫缩抑制剂治疗，70 名（45%）接受了硫酸镁治疗。分娩并发症影响了 11 名胎儿，有 12 名在产房或分娩室死亡；出院存活率为 75%（117/156），随着 GA 增加而增加：22 周时为 25%（1/4），23 周时为 75%（18/24），24 周时为 69%（29/42），25 周时为 73%（33/45），26 周时为 88%（36/41）（p=0.024）。双胎状态、产妇疾病或产科管理对结局无统计学重要影响。即使在专门的围产单位，极早产儿分娩的产前和产后产妇并发症也很常见，这强调了需要纳入母婴结局。
