围产期抗生素暴露和早产儿的呼吸系统结果
Ingmar Fortmann1,2, Amrei Welp3, Nele Hoffmann1
1Department of Pediatrics, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
JAMA network open
|May 12, 2025
概括
在早产婴儿中,反复暴露于抗生素与肺功能不佳和在学龄前喘风险增加有关. 这凸显了对高风险新生儿有针对性的呼吸支持的需要.
科学领域:
- 新生儿医学 新生儿医学
- 儿科肺病学 儿科肺病学
- 流行病学 流行病学
背景情况:
- 动物研究表明,早期接触抗生素和阻塞性呼吸道疾病之间存在联系.
- 关于早产婴儿这种关联的数据有限,需要进一步调查.
研究的目的:
- 为了确定是否在非常低出生体重 (VLBW) 的早产新生儿中重复的围产期抗生素暴露与早期学龄期的阻塞性呼吸道疾病有关.
主要方法:
- 一项基于人口的多中心队列研究,涉及58个德国新生儿网络中心的VLBW早产新生儿 (22-36周怀孕).
- 使用抗生素风险评分 (ARS) 量化了抗生素暴露,后期分析仅限于剖腹产后的参与者.
- 肺功能 (FEV1,FVC z得分) 和儿童喘发作在5-7岁时被评估.
主要成果:
- 较高的抗生素风险得分与小学年龄的1秒 (FEV1) z得分显著降低的强迫呼气体积有关.
- 增加的暴露水平与受损的强迫生命能力 (FVC) z分数相关.
- 更高的抗生素暴露也与儿童早期喘发作风险显著增加有关.
结论:
- 围产期抗生素暴露的多次发作与早产儿的肺功能受损有关.
- 早期识别高风险新生儿对于实施有针对性的战略来支持呼吸系统健康和优化长期结果至关重要.
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