在与风险因素相关的产前皮质类固醇管理的怀孕中,出生时的妊娠年龄:回顾性队列研究
Joachim Graf1, Harald Abele1,2, Jan Pauluschke-Fröhlich2
1Midwifery Science, Institute for Health Sciences, University Hospital Tübingen, Tübingen, Germany.
Frontiers in medicine
|January 24, 2024
概括
对于即将发生的早产 (PTB),产前皮质类固醇 (ACS) 在大多数诊断中没有显著改变出生时的妊娠年龄. 然而,胎儿感染综合征 (AIS) 和胎盘出血增加了极度不成熟的风险.
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:
- 在临近早产 (PTB) 的产前皮质类固醇 (ACS) 给药后,调查出生时的妊娠年龄.
- 量化晚期PTB和与各种诊断和风险因素相关的极端不成熟的发病率.
研究的目的:
- 分析ACS对即将出现PTB的妇女分娩结果的影响.
- 确定特定诊断/风险因素与晚期PTB和极度不成熟的发生之间的关联.
主要方法:
- 这是一项回顾性队列研究,评估了2016年德国莱兰-柏林州的1544例出生情况.
- 分析包括频率,子组 (奇平方,弗里德曼测试),多项逻辑和线性回归.
- 计算了几率比率 (OR) 来评估极度不成熟的PTB风险.
主要成果:
- 52%的患者经历了晚期PTB,8%的患者在ACS后具有极度不成熟的PTB.
- 胚胎感染综合征 (AIS) 与显著较低的妊娠年龄 (平均207天) 有关.
- AIS (OR=5.57) 和胎盘出血 (OR=2.10) 显著增加了极度不成熟的PTB的风险.
结论:
- 虽然ACS对于胎儿肺部成熟至关重要,但特定的疾病,如AIS和胎盘出血,对极端不成熟的风险更高.
- 需要进一步的研究来完善基于个体风险因素和诊断的治疗策略.
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