晚期早产前皮质类固醇在孕期和妊娠期糖尿病怀孕
Lylach Haizler-Cohen1, Maria C Alzamora1, Nicole R Legro1
1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, MedStar Washington Hospital Center, Washington, District of Columbia.
American journal of perinatology
|June 2, 2025
概括
在糖尿病怀孕中,晚期早产前皮质类固醇 (ACS) 并没有增加新生儿低血糖症或改善整体呼吸系统问题. 然而,在某些情况下,完整的ACS课程确实减少了对呼吸支的需求.
科学领域:
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 新生儿科学 新生儿科学
- 内分泌学 在内分泌学.
背景情况:
- 晚期早产给新生儿带来风险,特别是那些暴露于母亲糖尿病的新生儿.
- 产前皮质类固醇 (ACS) 用于成熟胎儿肺部,但它们在晚期早产期糖尿病怀孕中的作用仍在争论中.
- 新生儿低血糖和呼吸道并发症是孕期糖尿病 (PGDM) 和孕期糖尿病 (GDM) 的母亲生下的婴儿的重大问题.
研究的目的:
- 评估晚期早产前皮质类固醇 (ACS) 和新生儿低血糖症之间的关联.
- 评估晚期早产期ACS对患有PGDM和GDM母亲出生的新生儿呼吸道并发症的影响.
- 探索糖尿病类型和血糖控制对这些关联的影响.
主要方法:
- 多中心回顾性队列研究 (2016-2022年) 包括晚期早产期的PGDM或GDM孕妇.
- 主要结局:新生儿低血糖症. 二次结局:复合呼吸道发病率,新生儿重症监护室入院,新生儿重症监护室停留时间,新生儿死亡.
- 多变量回归模型根据入院指示,妊娠年龄和出生体重进行调整;根据糖尿病类型,ACS完成和PGDM的血糖控制进行分层分析.
主要成果:
- 在PGDM或GDM分组中,ACS和非ACS组之间新生儿低血糖或复合呼吸道发病率没有显著差异.
- 晚期早产期ACS的完整疗程与减少补充氧气使用,机械通风和呼吸困扰综合征有关.
- 在PGDM怀孕中,新生儿结局在ACS和非ACS组之间没有差异,无论血糖控制如何.
结论:
- 在糖尿病怀孕中晚期早产ACS的使用与新生儿低血糖症的增加或复合呼吸道疾病的改善无关.
- 晚期早产性ACS的完整疗程可能会给呼吸系统带来好处,特别是减少对呼吸系统支持的需求.
- 母亲血糖控制似乎不会改变与糖尿病怀孕中晚期早产ACS使用相关的新生儿结局.
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