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有哪些证据?早产风险患者产前使用皮质类固醇的最新情况。

What is the evidence? Updates in the use of antenatal corticosteroids for patients at risk of preterm birth.

作者信息

Gulersen Moti, Gyamfi-Bannerman Cynthia

机构信息

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Diego, La Jolla, CA, USA.

出版信息

Eur J Obstet Gynecol Reprod Biol X. 2024 Nov 13;24:100352. doi: 10.1016/j.eurox.2024.100352. eCollection 2024 Dec.

Abstract

Antenatal corticosteroids have long been considered one of the most important antenatal therapies available for pregnant patients at risk of preterm birth based on the associated reduction of neonatal morbidity and mortality following their administration. However, despite decades of research since their incorporation into routine clinical practice, a number of key questions related to antenatal corticosteroid use remain. These include evaluating the impact of antenatal corticosteroids at gestational ages outside of the previously recommended window of 24 0/7-33 6/7 weeks of gestation, determining factors associated with optimal steroid timing in order to reduce unnecessary exposure, alterations in its dosing regimen, and their long-term impact. The purpose of this document is to review the latest evidence on antenatal corticosteroids and recent developments in emerging topics related to their use.

摘要

长期以来,产前使用皮质类固醇一直被认为是对有早产风险的孕妇最重要的产前治疗方法之一,因为使用后可降低新生儿发病率和死亡率。然而,尽管自其纳入常规临床实践以来已进行了数十年研究,但与产前使用皮质类固醇相关的一些关键问题仍然存在。这些问题包括评估产前皮质类固醇在先前推荐的妊娠24 0/7 - 33 6/7周孕周范围之外的影响,确定与最佳类固醇使用时机相关的因素以减少不必要的暴露,其给药方案的改变以及它们的长期影响。本文的目的是回顾关于产前皮质类固醇的最新证据以及与其使用相关的新兴主题的最新进展。

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Antenatal Corticosteroids at 21-23 Weeks of Gestation.妊娠21至23周时使用产前皮质类固醇。
Obstet Gynecol. 2024 Jan 1;143(1):35-43. doi: 10.1097/AOG.0000000000005352. Epub 2023 Sep 13.
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Practice patterns in the administration of late preterm antenatal corticosteroids.晚期早产产前使用糖皮质激素的实践模式
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