Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.
Ultrasound Obstet Gynecol. 2023 Feb;61(2):191-197. doi: 10.1002/uog.26127.
To evaluate the role of antenatal administration of corticosteroids for fetal lung maturation on the short-term perinatal outcome of pregnancy complicated by late fetal growth restriction (FGR).
This cohort study was a secondary analysis of a multicenter prospective observational study, the TRUFFLE-2 feasibility study, conducted between 2017 and 2018 in 33 European perinatal centers. The study included women with a singleton pregnancy from 32 + 0 to 36 + 6 weeks of gestation with a fetus considered at risk for FGR, defined as estimated fetal weight (EFW) and/or fetal abdominal circumference < 10 percentile, or umbilicocerebral ratio (UCR) ≥ 95 percentile or a drop of more than 40 percentile points in abdominal circumference measurement from the 20-week scan. For the purposes of the current study, we identified women who received a single course of steroids to improve fetal lung maturation before delivery. Each exposed pregnancy was matched with one that did not receive antenatal corticosteroids (ACS) (control), based on gestational age at delivery and birth weight. The primary adverse outcome was a composite of abnormal condition at birth, major neonatal morbidity or perinatal death.
A total of 86 pregnancies that received ACS were matched to 86 controls. The two groups were similar with respect to gestational age (33.1 vs 33.3 weeks), EFW (1673 vs 1634 g) and UCR (0.68 vs 0.62) at inclusion, and gestational age at delivery (35.5 vs 35.9 weeks) and birth weight (1925 vs 1948 g). No significant differences were observed between the exposed and non-exposed groups in the incidence of composite adverse outcome (28% vs 24%; P = 0.73) or any of its elements.
The present data do not show a beneficial effect of steroids on short-term outcome of fetuses with late FGR. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
评估产前应用皮质类固醇促进胎儿肺成熟对晚期胎儿生长受限（FGR）妊娠围生期近期结局的作用。
这是一项队列研究，对 2017 年至 2018 年在 33 个欧洲围产中心进行的多中心前瞻性观察性研究 TRUFFLE-2 可行性研究进行了二次分析。该研究纳入了孕周 32+0 至 36+6 周且胎儿被认为有发生 FGR 风险的单胎妊娠孕妇，定义为估计胎儿体重（EFW）和/或胎儿腹围<第 10 百分位数，或脐脑比（UCR）≥第 95 百分位数，或腹围测量值较 20 周扫描时下降超过 40 个百分点。为了进行本研究，我们确定了在分娩前接受单疗程类固醇以改善胎儿肺成熟度的孕妇。根据分娩时的胎龄和出生体重，每例接受皮质类固醇治疗的孕妇（暴露组）与未接受产前皮质类固醇（ACS）治疗的孕妇（对照组）进行匹配。主要不良结局是出生时异常情况、严重新生儿发病率或围产儿死亡的复合结局。
共有 86 例接受 ACS 的妊娠与 86 例对照匹配。两组在纳入时的胎龄（33.1 与 33.3 周）、EFW（1673 与 1634 g）和 UCR（0.68 与 0.62）相似，分娩时的胎龄（35.5 与 35.9 周）和出生体重（1925 与 1948 g）也相似。暴露组与未暴露组在复合不良结局（28%与 24%；P=0.73）或其任何单一成分的发生率方面均无显著差异。
目前的数据并未显示皮质类固醇对晚期 FGR 胎儿短期结局有有益作用。© 2023 作者。超声在妇产科由 John Wiley & Sons Ltd 出版，代表国际妇产科超声学会。
