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产前皮质类固醇对于小的妊娠年龄在晚期早产的新生儿
Keren Zloto1, Eyal Krispin2, Anat Shmueli2
1Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
The Israel Medical Association journal : IMAJ
|October 17, 2023
概括
产前皮质类固醇 (ACS) 并没有改善妊娠年龄 (SGA) 小的晚期早产新生儿的呼吸结果. 这种治疗可能与这种脆弱人群的不良围产期结局有关.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿周产医学 新生儿周产医学
- 公共卫生 公共卫生
背景情况:
- 产前皮质类固醇 (ACS) 是威胁过早分娩的标准,但它们对怀孕年龄小 (SGA) 的晚期过早新生儿的益处尚不清楚.
- 晚期早产 (34-36周) 影响大量新生儿,SGA婴儿代表高风险群体.
研究的目的:
- 评估产前皮质类固醇 (ACS) 对晚期早产婴儿 (SGA) 新生儿产周结果的影响.
- 为了确定ACS的管理是否改善或恶化呼吸系统和其他新生儿的结果在这个特定的人群.
主要方法:
- 对SGA新生儿单子妊娠与晚期早产 (34-36周) 的回顾性队列研究.
- 暴露于ACS和未暴露的新生儿之间围产期结局的比较.
- 新生儿综合结局包括NICU入院,呼吸困扰综合征,机械通风和短暂的短暂呼吸.
主要成果:
- 在ACS组中观察到更高的NICU入院率 (53.92%对31.74%) 和需要光疗的黄 (12.74%对5.55%).
- 在ACS组中,综合新生儿结局显著更高 (53.92%对32.53%,或2.42),在混调整 (或2.15) 后仍然存在.
- 在ACS组中,中位出生体重明显较低 (1755.5g vs 1896.0g).
结论:
- 产前皮质类固醇 (ACS) 没有证明改善了妊娠年龄 (SGA) 晚期早产新生儿的呼吸结果.
- 在怀孕期间使用ACS可能会增加SGA晚期早产婴儿出现不良周产期结果的风险,包括NICU入院和黄.
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