在重复暴露于产前皮质类固醇后,新生儿呼吸困扰综合征:一项随机对照试验
Caroline A Crowther1, Ross R Haslam, Janet E Hiller
1Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia 5006, Australia. caroline.crowther@adelaide.edu.au
Lancet (London, England)
|June 13, 2006
概括
重复的产前皮质类固醇剂量显著减少了早产风险的婴儿的呼吸困扰综合征和严重的肺部疾病. 这些发现支持在初始疗程后仍然存在风险的女性中使用它们.
科学领域:
- 新生儿医学 新生儿医学
- 产科 产科 产科 产科 产科
- 药理学 药理学是指药理学的学科.
背景情况:
- 重复产前皮质类固醇的安全性和有效性仍在研究中.
- 产前皮质类固醇用于减少新生儿发病率,以减少早产风险.
研究的目的:
- 为了确定重复的产前皮质类固醇剂量是否会减少新生儿发病率而不会造成伤害.
- 评估重复的皮质类固醇疗程对呼吸困扰综合征和其他新生儿结局的影响.
主要方法:
- 一项随机对照试验,涉及982名女性,她们在怀孕32周之前面临早产风险.
- 妇女每周接受肌肉内注射剂量的贝他美沙或安慰剂,如果他们仍然未分娩和有风险.
- 主要结局包括新生儿呼吸困扰综合征,氧气和通风使用,以及人体测量.
主要成果:
- 重复的皮质类固醇暴露导致呼吸困难综合征 (33%vs. 41%) 和严重的肺部疾病 (12%vs. 20%) 的显著减少.
- 暴露于重复皮质类固醇的婴儿需要更少的氧气治疗和更短的机械通风持续时间.
- 虽然出生人体测量显示Z分数存在一些差异,但在出院时这些差异并不显著.
结论:
- 重复的产前皮质类固醇管理有效地减少了短期新生儿发病率.
- 观察到的好处支持在极早分娩风险较高的妇女中使用重复的皮质类固醇剂量.
- 长期结果数据尚未公布,但短期结果是有希望的.
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