Division of Neonatology, Department of Paediatrics, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):9105-9111. doi: 10.1080/14767058.2021.2015576. Epub 2021 Dec 12.
Infants who are born at 34° to 36weeks of gestation (late preterm) are at greater risk for respiratory and other neonatal morbidities. The objective of this study was to examine the effects of the administration of antenatal corticosteroids (ACS) to women at risk for late preterm delivery on the incidence of neonatal outcomes.
This was a prospective cohort study of singleton gestations at risk of imminent delivery between 34° and 36weeks. Neonatal outcomes were compared between mothers who received ACS and those who did not. The primary outcome was the rate of composite respiratory morbidity defined as the need for treatment within 72 h of life (continuous positive airway pressure or high flow nasal cannula for least 2 h or supplemental oxygen with a fraction of inspired oxygen of at least 0.30 for at least four continuous hours or mechanical ventilation).
During the 3-year study period, 595 subjects were included in this study, comprising 234 subjects that received ACS and 361 that did not. Administration of ACS significantly reduced the rates of composite respiratory morbidity (aOR 0.63 95% CI 0.40-0.99), the use of CPAP or HFNC for at least 2 h (aOR 0.57 95% CI 0.35-0.94), and transient tachypnea of the newborn (aOR 0.48 95% CI 0.28-0.82). Neonatal hypoglycemia was more significantly increased in the ACS group compared with controls (aOR 1.64 95% CI 1.04-2.59). We found no significant between-group differences in the rate of respiratory distress syndrome, surfactant use, need for resuscitation, jaundice requiring phototherapy, admission to neonatal intensive care or special care nursery, and duration of hospitalization.
Administration of ACS during the late preterm period decreased neonatal respiratory complications, however, increased the rate of hypoglycemia.
在妊娠 34 至 36 周（晚期早产）出生的婴儿患呼吸和其他新生儿疾病的风险更高。本研究的目的是研究对有晚期早产风险的妇女给予产前皮质类固醇（ACS）对新生儿结局的影响。
这是一项对有即将在 34 至 36 周之间分娩风险的单胎妊娠进行的前瞻性队列研究。比较接受 ACS 和未接受 ACS 的母亲的新生儿结局。主要结局是复合呼吸发病率的发生率，定义为在生命的头 72 小时内需要治疗（持续气道正压通气或高流量鼻导管至少 2 小时，或补充氧气，吸入氧分数至少 0.30，持续至少 4 小时，或机械通气）。
在 3 年的研究期间，共有 595 名受试者纳入本研究，其中 234 名受试者接受了 ACS，361 名受试者未接受 ACS。ACS 的使用显著降低了复合呼吸发病率（aOR 0.63，95%CI 0.40-0.99）、CPAP 或 HFNC 至少使用 2 小时（aOR 0.57，95%CI 0.35-0.94）和新生儿暂时性呼吸急促（aOR 0.48，95%CI 0.28-0.82）的发生率。与对照组相比，ACS 组新生儿低血糖的发生率显著增加（aOR 1.64，95%CI 1.04-2.59）。我们没有发现两组之间在呼吸窘迫综合征的发生率、表面活性剂的使用、需要复苏、需要光疗的黄疸、入住新生儿重症监护病房或特殊护理病房以及住院时间方面有显著差异。
在晚期早产期间给予 ACS 可降低新生儿呼吸并发症的发生率，但会增加低血糖的发生率。
