在极低妊娠年龄的新生儿中产后类固醇暴露和24个月的功能,经过年龄校正
Meredith P Schuh1, Russel Griffin2, Cara Slagle3
1Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
Kidney360
|April 21, 2025
概括
在早产婴儿中产后使用皮质类固醇可能会影响功能. 特定的时间和持续时间,特别是用皮和早期的甲甲,与24个月校正年龄的功能 (GFR) 降低有关.
科学领域:
- 新生儿医学 新生儿医学
- 儿科脏病学 儿科脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 过早分娩与较低的脏捐赠和慢性脏病 (CKD) 的风险增加有关.
- 产前皮质类固醇 (ANS) 是早产新生儿肺部成熟度的标准.
- 产后皮质类固醇对功能的影响在很大程度上是未知的.
研究的目的:
- 为了研究产后皮质类固醇时间和持续时间对早产婴儿24个月校正年龄的功能的影响.
- 评估不同产后皮质类固醇治疗方案与估计的淋巴球过率 (eGFR) 之间的关联.
主要方法:
- 从怀孕28周以下的新生儿身上获得的PENUT试验数据的二次分析.
- 包括存活的婴儿,血清肌素测量在22-26个月的纠正妊娠年龄 (cGA).
- 对产后类固醇的评估暴露 (类型,开始日期,持续时间) 和降低EGFR (<90毫升/分钟/1.73米2) 的初级结果.
主要成果:
- 在348名被评估的婴儿中,61名 (17.5%) 的GFR有所降低.
- 1-7天使用皮与减少GFR的概率增加了2.8倍.
- 与较晚的启动 (≥29周的PMA) 相比,早期开始使用德克萨 (≤25周的月经后年龄) 显示,减少GFR的几率增加了9.39倍.
结论:
- 观察数据表明,产后皮质类固醇时间,持续时间和早产婴儿功能减弱 (GFR) 之间存在关联.
- 需要进一步的研究来阐明这些关联,并为保护这个脆弱人群的长期脏健康制定策略.
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