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出生后皮质类固醇对支气管肺发育不良婴儿生长参数的影响。

The effect of postnatal corticosteroids on growth parameters in infants with bronchopulmonary dysplasia.

机构信息

Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College, London, UK.

Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK.

出版信息

J Perinat Med. 2021 Jun 7;49(9):1141-1144. doi: 10.1515/jpm-2021-0149. Print 2021 Nov 25.

Abstract

OBJECTIVES

Corticosteroids are administered to ventilator dependent infants with bronchopulmonary dysplasia (BPD) to improve respiratory function and facilitating extubation. Acutely, however, growth impairment can occur as a side effect of such therapy. We aimed to determine the effect of corticosteroids on postnatal growth during the entire neonatal intensive care unit (NICU) admission.

METHODS

A whole population study of extremely preterm infants with BPD was undertaken. Corticosteroid therapy was classified as treatment with dexamethasone or hydrocortisone for a least five consecutive days. Growth was calculated as the difference in weight and head circumference -score from birth to discharge.

RESULTS

Six thousand, one hundred and four infants with BPD were included of whom 28.3% received postnatal corticosteroids. Infants receiving corticosteroids were less mature (GA 25.0 vs. 26.3 weeks) and of lower birthweight (0.70 vs. 0.84 kg) than those not receiving treatment. There were no significant differences between those who did and did not receive corticosteroids in weight gain (p=0.61) or head circumference growth (p=0.33) from birth to discharge. Single vs. multiple courses of postnatal corticosteroids did not result in significant differences in weight (p=0.62) or head circumference (p=0.13) growth.

CONCLUSIONS

Postnatal corticosteroid treatment did not affect the longer term growth of preterm infants with BPD.

摘要

目的

给予患有支气管肺发育不良(BPD)的呼吸机依赖婴儿皮质类固醇以改善呼吸功能并促进拔管。然而,这种治疗的急性副作用可能会导致生长受损。我们旨在确定皮质类固醇对整个新生儿重症监护病房(NICU)入院期间的新生儿生长的影响。

方法

对患有 BPD 的极早产儿进行了全人群研究。皮质类固醇治疗被定义为至少连续五天接受地塞米松或氢化可的松治疗。生长被计算为出生至出院时体重和头围 - 评分的差异。

结果

纳入了 6104 名患有 BPD 的婴儿,其中 28.3%接受了产后皮质类固醇治疗。接受皮质类固醇治疗的婴儿比未接受治疗的婴儿更不成熟(GA 25.0 对 26.3 周),出生体重更低(0.70 对 0.84 公斤)。接受和未接受皮质类固醇治疗的婴儿从出生到出院时体重增加(p=0.61)或头围生长(p=0.33)没有显着差异。单次与多次接受产后皮质类固醇治疗在体重(p=0.62)或头围(p=0.13)生长方面没有显着差异。

结论

产后皮质类固醇治疗不会影响患有 BPD 的早产儿的长期生长。

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