单中心研究：晚期早产儿产前使用类固醇与婴儿结局
Late preterm antenatal steroid use and infant outcomes in a single center.
机构信息
Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA.
Oregon Health & Science University School of Medicine, Portland, OR, USA.
出版信息
J Perinatol. 2024 Jul;44(7):1009-1013. doi: 10.1038/s41372-024-01934-2. Epub 2024 Mar 18.
OBJECTIVE
To characterize late preterm antenatal steroids (AS) use and associated neonatal outcomes in a single academic center.
STUDY DESIGN
Retrospective study of 503 singleton, mother-infant dyads delivered between 34 0/7 and 36 6/7 weeks gestation between January 1, 2016 and December 31, 2020.
RESULTS
Forty-three percent did not receive AS (No AS) prior to delivery. Among AS treated, 50% were sub-optimal dosing. No AS had higher preterm premature rupture of membranes and maternal diabetes. AS group had lower mean gestational age, birthweight, longer time from admission to delivery and longer NICU stay. There was no difference in neonatal hypoglycemia.
CONCLUSIONS
Sub-optimal AS dosing in late preterms remains high in our center. AS did not improve neonatal outcomes. Studies are needed to evaluate the impact of AS in diabetics delivering late preterm, to optimize the timing of AS dosing, and evaluate the longer term impact on late preterm infants.
目的
在单家学术中心描述晚期早产儿产前皮质类固醇（AS）的使用情况及其与新生儿结局的相关性。
研究设计
这是一项回顾性研究，纳入了 2016 年 1 月 1 日至 2020 年 12 月 31 日期间在 34 0/7 至 36 6/7 周分娩的 503 例单胎母婴对。
结果
43%的患者在分娩前未接受 AS（无 AS）治疗。在接受 AS 治疗的患者中，50%存在剂量不足。无 AS 治疗的患者中，胎膜早破和母亲患有糖尿病的比例更高。AS 组的平均胎龄、出生体重更低，从入院到分娩的时间更长，新生儿重症监护病房（NICU）住院时间更长。两组新生儿低血糖的发生率无差异。
结论
我们中心晚期早产儿的 AS 剂量不足仍然较高。AS 并不能改善新生儿结局。需要研究评估 AS 在糖尿病孕妇晚期早产分娩中的作用，优化 AS 剂量的时机，并评估其对晚期早产儿的长期影响。
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