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产前或产后皮质类固醇有利于早产儿皮质激素治疗早产羔羊的临床、呼吸、代谢结果和氧化平衡。

Prenatal or postnatal corticosteroids favor clinical, respiratory, metabolic outcomes and oxidative balance of preterm lambs corticotherapy for premature neonatal lambs.

机构信息

Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Rua Prof. Orlando Marques de Paiva, 87, Cidade Universitária, São Paulo, SP, 05508-270, Brazil.

Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Rua Prof. Orlando Marques de Paiva, 87, Cidade Universitária, São Paulo, SP, 05508-270, Brazil.

出版信息

Theriogenology. 2022 Apr 1;182:129-137. doi: 10.1016/j.theriogenology.2022.02.006. Epub 2022 Feb 8.

DOI:10.1016/j.theriogenology.2022.02.006
PMID:35168015
Abstract

Challenges of the extrauterine environment can be life threatening for a premature fetus with inadequate fetal maturity. Maternal corticosteroids therapy is widely employed to induce fetal pulmonary maturation. Nevertheless, whenever therapeutic pregnancy interruption has to be performed in a time manner insufficient to treat the dam, postnatal corticotherapy can be considered an alternative. However, it is not known if antenatal and postnatal corticotherapy can improve similarly neonatal outcomes and pulmonary function. This research aimed to analyze antenatal and postnatal corticotherapy on premature lambs vitality, pulmonary functioning, metabolic and oxidative status. Lambs were evaluated according to the mode of treatment: Prenatal Corticosteroid Group (8 lambs born after maternal betamethasone treatment 48 h prior to birth), Postnatal Corticosteroid Group (9 lambs subjected to betamethasone treatment 10 min after birth) and Control Group (5 lambs remained untreated). Lambs were medically followed-up from birth to 72 h thereafter through a complete physical examination, as well as lactatemia, glycaemia, blood acid-base balance and antioxidant status. Treated lambs had higher vitality score than the Control Group. Heart rate was higher in postnatal therapy compared to prenatal treatment. Respiratory rate and rectal temperature were higher in treated groups. Treated lambs had hyperglycemia, while the Postnatal Group had higher lactatemia than the Control Group. The Prenatal Group had lower and normal pCO from 60 min onwards. The Postnatal Group had higher superoxide dismutase activity than untreated lambs. In conclusion, prenatal and postnatal betamethasone treatments favor neonatal clinical outcome, respiratory function, glucose homeostasis and oxidative balance.

摘要

子宫外环境的挑战对胎儿成熟度不足的早产儿可能是致命的。母亲皮质类固醇治疗被广泛用于诱导胎儿肺成熟。然而,每当治疗性妊娠中断必须在不足以治疗母体的时间内进行时,可以考虑产后皮质激素治疗作为替代方案。然而,尚不清楚产前和产后皮质激素治疗是否可以类似地改善新生儿结局和肺功能。本研究旨在分析产前和产后皮质激素治疗对早产羔羊活力、肺功能、代谢和氧化状态的影响。根据治疗方式对羔羊进行评估:产前皮质类固醇组(8 只在出生前 48 小时接受母亲倍他米松治疗后出生的羔羊)、产后皮质类固醇组(9 只在出生后 10 分钟接受倍他米松治疗的羔羊)和对照组(5 只未接受治疗的羔羊)。从出生到出生后 72 小时,对羔羊进行全面的身体检查,以及乳清酸血症、血糖、血液酸碱平衡和抗氧化状态的随访。治疗组的羔羊活力评分高于对照组。与产前治疗相比,产后治疗的心率更高。治疗组的呼吸频率和直肠温度更高。治疗组的羔羊出现高血糖,而产后组的羔羊比对照组的羔羊乳酸血症更高。产前组从 60 分钟开始 pCO2 较低且正常。与未治疗的羔羊相比,产后组的超氧化物歧化酶活性更高。结论:产前和产后倍他米松治疗有利于新生儿临床结局、呼吸功能、葡萄糖稳态和氧化平衡。

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