产前皮质类固醇:预期益处和潜在风险的最新评估
Alan H Jobe1, Robert L Goldenberg2, Matthew W Kemp3
1Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
American journal of obstetrics and gynecology
|September 21, 2023
概括
产前类固醇治疗早产是标准的,但它的有效性各不相同. 研究正在探索不同妊娠年龄和资源设置的最佳使用和风险.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿医学 新生儿医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 在高资源环境中,产前类固醇治疗是即将发生的早产 (妊娠24至34周) 的标准.
- 目前的使用范围从怀孕22周到39周+6周,并有不断发展的应用.
- 现有的数据主要来自高资源,白人人口,促使研究在低和中资源环境.
研究的目的:
- 审查产前类固醇的当前应用和不断发展的使用情况.
- 为了突出有效性和益处风险平衡在整个怀孕期间的变化.
- 解决对优化疗法和风险和益处的明确沟通的需求.
主要方法:
- 审查现有的随机对照试验数据.
- 对近期研究的分析,对可生育,晚期早产和终产的人群进行分析.
- 对药理动力学和药理动力学数据进行检查,以优化治疗方案.
主要成果:
- 产前类固醇治疗的疗效是高度可变的,治疗方案往往是任意的.
- 益处与风险的平衡受到妊娠年龄的显著改变.
- 基于人口的研究表明,与儿童精神疾病和新生儿感染的潜在关联.
结论:
- 产前类固醇治疗需要仔细考虑妊娠年龄和资源设置.
- 根据药理动力学和药理动力学优化治疗方案至关重要.
- 需要明确阐明好处和危害,以获得患者知情同意和临床实践.
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