对产前类固醇暴露对胎儿发育的潜在非目标影响的审查
Sean W D Carter1,2,3, Matthew W Kemp1,3,4
1Department of Obstetrics and Gynaecology, National University of Singapore, Singapore, Singapore.
Journal of developmental origins of health and disease
|March 26, 2025
概括
产前类固醇 (ANS) 通过促进肺部成熟来减少早产婴儿的并发症. 然而,本次审查强调了对胎儿发育的潜在不良影响,敦促进一步研究和谨慎使用.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿科学 新生儿科学
- 发展生物学 发展生物学
背景情况:
- 产前类固醇 (ANS) 经常给那些有早产风险的孕妇.
- 有证据表明,ANS通过在妊娠35周之前增强胎儿肺部成熟来降低围产期发病率和死亡率.
- 扩大ANS的使用需要评估对更广泛的胎儿发育潜在的非目标不良影响.
研究的目的:
- 进行叙事文献审查,评估目前关于产前类固醇暴露对胎儿发育的不良影响的证据.
- 总结关于ANS治疗对胎儿发育和编程可能产生广泛的,非目标的不良影响的研究结果.
主要方法:
- 进行了叙事文学评论.
- 该综述综合了来自动物和临床研究的有关产前类固醇暴露和胎儿发育的数据.
主要成果:
- 有证据表明,在肺成熟之后,ANS对胎儿发育的潜在不良影响.
- 关于ANS对胎儿免疫,心血管,脏和肝脏系统的影响的证据非常稀缺.
- 在晚期早产和晚期怀孕中,ANS的好处是最小的.
结论:
- 迫切需要进一步的动物和临床研究来调查ANS对胎儿免疫,心血管,和肝系统的影响.
- 强烈建议对临床医生和患者公开披露ANS的好处和风险,特别是在晚期早产和满期怀孕.
- 建议通过改善患者选择和剂量方案,根据药理动力学和药理动力学来优化ANS治疗.
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