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产前使用糖皮质激素与分娩之间的时间间隔对糖尿病母亲所生晚期早产儿结局的影响:一项回顾性队列研究。

The effect of time interval between antenatal corticosteroid administration and delivery on outcomes in late preterm neonates born to mothers with diabetes: a retrospective cohort study.

作者信息

Li Xiaoyu, Zhang Jing, Hao Qingfei, Du Yanna, Cheng Xiuyong

机构信息

Department of Neonatology, The First Affiliated Hospital of Zheng Zhou University, Zhengzhou, China.

出版信息

Front Pediatr. 2023 Aug 25;11:1239977. doi: 10.3389/fped.2023.1239977. eCollection 2023.

Abstract

OBJECTIVES

The study aims to investigate whether the time interval between administering antenatal corticosteroids (ACS) and delivery influences the neonatal outcomes in late preterm (LPT) neonates (34 + 0 to 36 + 6 weeks) born to mothers with diabetes.

STUDY DESIGN

This retrospective cohort study included women with any type of diabetes who gave birth between 34 + 0 weeks and 36 + 6 weeks of gestation. Based on the time interval between the first dose of corticosteroid and delivery, the cases were stratified into the following groups: <2, 2-7, and >7 days. Women unexposed to ACS served as the control group. The primary outcomes included the incidence of neonatal hypoglycemia and respiratory distress syndrome/transient tachypnea of the newborn. Multivariate logistic regression was used to assess the relationship between the time interval and neonatal outcomes and adjust for potential confounders.

RESULTS

The study enrolled a total of 636 parturients. Among them, 247 (38.8%) delivered within 2 days after ACS administration, 169 (26.6%) within 2-7 days, and 126 (19.8%) at >7 days. Baseline characteristics such as type of diabetes, methods of glycemic control, preterm premature rupture of membrane, placenta previa, cesarean delivery, indication for delivery, percentage of large for gestational age, birth weight, and HbA1c in the second or third trimester were significantly different among the four groups. The multivariate analysis showed no statistically significant difference in the incidence of primary or secondary neonatal outcomes between the case and control groups.

CONCLUSIONS

ACS treatment was not associated with neonatal hypoglycemia and respiratory outcomes in LPT neonates born to diabetic mothers, regardless of the time interval to delivery.

摘要

目的

本研究旨在调查产前使用糖皮质激素(ACS)与分娩之间的时间间隔是否会影响糖尿病母亲所生晚期早产儿(LPT,34⁺⁰至36⁺⁶周)的新生儿结局。

研究设计

这项回顾性队列研究纳入了在妊娠34⁺⁰周和36⁺⁶周之间分娩的任何类型糖尿病女性。根据首次使用糖皮质激素与分娩之间的时间间隔,将病例分为以下几组:<2天、2 - 7天和>7天。未接受ACS治疗的女性作为对照组。主要结局包括新生儿低血糖症和呼吸窘迫综合征/新生儿短暂性呼吸急促的发生率。采用多因素逻辑回归分析来评估时间间隔与新生儿结局之间的关系,并对潜在混杂因素进行校正。

结果

该研究共纳入636名产妇。其中,247名(38.8%)在接受ACS治疗后2天内分娩,169名(26.6%)在2 - 7天内分娩,126名(19.8%)在>7天分娩。四组之间的基线特征,如糖尿病类型、血糖控制方法、早产胎膜早破、前置胎盘、剖宫产、分娩指征、大于胎龄儿百分比、出生体重以及孕中期或孕晚期糖化血红蛋白水平存在显著差异。多因素分析显示,病例组和对照组之间原发性或继发性新生儿结局的发生率无统计学显著差异。

结论

无论至分娩的时间间隔如何,ACS治疗与糖尿病母亲所生LPT新生儿的低血糖症和呼吸结局均无关。

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