Gardner M O, Bronstein J, Goldenberg R L, Haywood J L, Cliver S P, Nelson K G
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, USA.
J Perinatol. 1996 Nov-Dec;16(6):431-4.
Our purpose was to compare physician opinions about the appropriate use of corticosteroids with physician perceptions of preterm infant outcome. A total of 409 obstetricians and family physicians who provide maternity care in Alabama were surveyed to determine whether (and how) their perceptions of preterm infant outcome influenced their decision to use antenatal corticosteroids. Results were compared with those of a similar survey of Alabama physicians conducted in 1979. A total of 85% of physicians in 1992 versus 61% in 1979 reported that situations existed in which they would prescribe antenatal corticosteroids (p < 0.001). In 1992 physicians who underestimated preterm infant survival began corticosteroid use at later gestational ages than those physicians who did not underestimate survival (p < 0.02). In addition, 54% of physicians who underestimated preterm infant survival reported giving corticosteroids between 23 and 28 weeks' gestational age versus 73% of physicians with more accurate perceptions (p < 0.03). We conclude that in 1992, compared within 1979, more Alabama physicians reported antenatal corticosteroid use. Use of this treatment was influenced by each physician's perceptions of the probable outcome of the preterm infant.
我们的目的是比较医生关于皮质类固醇恰当使用的观点与医生对早产婴儿结局的认知。对在阿拉巴马州提供产科护理的409名产科医生和家庭医生进行了调查，以确定他们对早产婴儿结局的认知是否（以及如何）影响他们使用产前皮质类固醇的决定。将结果与1979年对阿拉巴马州医生进行的类似调查结果进行比较。1992年，85%的医生报告存在会开具产前皮质类固醇的情况，而1979年这一比例为61%（p<0.001）。1992年，低估早产婴儿存活率的医生开始使用皮质类固醇的孕周比未低估存活率的医生更晚（p<0.02）。此外，低估早产婴儿存活率的医生中有54%报告在孕23至28周给予皮质类固醇，而认知更准确的医生中这一比例为73%（p<0.03）。我们得出结论，与1979年相比，1992年更多阿拉巴马州的医生报告使用产前皮质类固醇。这种治疗方法的使用受到每位医生对早产婴儿可能结局的认知的影响。
