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在低资源环境中产前皮质类固醇治疗,分娩间隔和产前死亡率
Stanley Mwita1, Benjamin Kamala2,3, Eveline Konje4
1Department of Pharmaceutics and Pharmacy Practice, Catholic University of Health and Allied Sciences, Mwanza 33109, Tanzania.
Journal of tropical pediatrics
|November 22, 2023
概括
在产前48小时至产前7天之间给予产前皮质类固醇 (ACS),而不是在48小时内,可显著降低早产婴儿周围死亡率和呼吸应急综合征 (RDS) 的风险.
科学领域:
- 产周医学 产周医学
- 新生儿护理 新生儿护理
- 产科 产科 产科 产科 产科
背景情况:
- 在分娩前服用产前皮质类固醇 (ACS) 的最佳时间仍然不确定.
- ACS对于早产婴儿肺部成熟至关重要.
研究的目的:
- 评估ACS施用时间和新生儿结果之间的关联.
- 根据ACS分娩间隔,比较围产期死亡率和呼吸应急综合征 (RDS) 的风险.
主要方法:
- 在坦桑尼亚 (2020年) 进行的一项前性观察图表审查研究的二次分析.
- 包括28-34周怀孕期间接受ACS的母亲产生的早产婴儿.
- 在ACS注射后48小时内与48小时至7天内分娩的结果进行比较.
主要成果:
- 在ACS发生后48小时至7天出生的婴儿,产周死亡率和RDS显著降低.
- 多变量分析显示,在这个群体中,围产死亡率 (aRR 0.30) 和RDS (aRR 0.27) 的风险降低.
- 研究包括346名早产新生儿 (294名单胎,52名双胞胎).
结论:
- 在分娩前48小时至7天之间给予第一剂ACS与更好的新生儿结局有关.
- 与在48小时内给予药物相比,这种时间与围产死亡率和RDS风险较低有关.
- 医疗保健提供者应考虑这种最佳窗口用于ACS的管理,以改善新生儿的结果.
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