Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, United States.
Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, United States.
Neurosci Biobehav Rev. 2023 Feb;145:105034. doi: 10.1016/j.neubiorev.2023.105034. Epub 2023 Jan 3.
Glucocorticoids (GC) are used in neonatal intensive care units to prevent or reduce the severity of chronic lung disease in preterm infants and have been implicated in impaired neurodevelopment. Our objective was to identify what is known about the effects of postnatal GC treatment in human preterm infants on structural brain development and to identify gaps in the literature. Following Arksey and O'Malley's scoping review methodological framework, we searched scientific literature databases for original research on human preterm infants, postnatal GCs, and brain structure. 11 studies assessed the effects of GCs on structural brain outcomes. 56 studies reported brain injury, but not structure. Dexamethasone was consistently associated with decreased total and regional brain volumes, including cerebellar volumes. Hydrocortisone was often, but not always associated with absence of brain volume differences. No studies examined the impact of inhaled GC on brain structure. Additional research on the effects of neonatal GCs after preterm birth on a variety of structural brain measures is required for understanding contributions to neurodevelopment and informing practice guidelines.
糖皮质激素（GC）在新生儿重症监护病房中被用于预防或减轻早产儿慢性肺病的严重程度，并与神经发育受损有关。我们的目的是确定已知的关于出生后 GC 治疗对人类早产儿大脑结构发育的影响，并确定文献中的空白。根据 Arksey 和 O'Malley 的范围综述方法框架，我们在科学文献数据库中搜索了关于人类早产儿、出生后 GC 和大脑结构的原始研究。11 项研究评估了 GC 对大脑结构结果的影响。56 项研究报告了脑损伤，但未报告结构。地塞米松始终与总脑体积和区域脑体积减少相关，包括小脑体积。氢化可的松通常与脑体积差异无关，但并非总是如此。没有研究检查吸入性 GC 对大脑结构的影响。需要对早产儿出生后新生儿 GC 的各种结构脑测量结果的影响进行更多研究，以了解对神经发育的贡献并为实践指南提供信息。
