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从新冠疫情角度看产前皮质类固醇

Antenatal corticosteroids in COVID-19 perspective.

作者信息

Vidaeff Alex C, Aagaard Kjersti M, Belfort Michael A

机构信息

Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Texas Children's Hospital, Baylor College Medicine, Houston, TX 77030, United States.

出版信息

World J Exp Med. 2021 Sep 20;11(4):37-43. doi: 10.5493/wjem.v11.i4.37.

Abstract

The aim of this manuscript is to discuss the practice of antenatal corticosteroids administration for fetal maturation in severe acute respiratory syndrome coronavirus 2 positive pregnant women. Recent high-quality evidence supports the use of dexamethasone in the treatment of hospitalized patients with coronavirus disease 2019 (COVID-19). Randomized disease outcome data have identified an association between disease stage and treatment outcome. In contrast to patients with more severe forms who benefit from dexamethasone, patients with mild disease do not appear to improve and may even be harmed by this treatment. Therefore, indiscriminate usage of fluorinated corticosteroids for fetal maturation, regardless of disease trajectory, is unadvisable. Obstetrical care needs to be adjusted during the COVID-19 pandemic with careful attention paid to candidate selection and risk stratification.

摘要

本手稿的目的是讨论在新型冠状病毒2型阳性孕妇中使用产前皮质类固醇促进胎儿成熟的做法。最近的高质量证据支持地塞米松用于治疗2019冠状病毒病(COVID-19)住院患者。随机疾病结局数据已确定疾病阶段与治疗结局之间的关联。与受益于地塞米松的更严重形式的患者不同,轻症患者似乎没有改善,甚至可能因这种治疗而受到伤害。因此,无论疾病轨迹如何,不加区分地使用氟化皮质类固醇促进胎儿成熟是不可取的。在COVID-19大流行期间,产科护理需要调整,要仔细关注候选者的选择和风险分层。

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