系统性皮质类固醇使用和早产婴儿的神经发育结果:一个队列研究
Adithya Shastry1,2, Danish Ahmad2, Alice Richardson3
1Department of Neonatology, The Australian National University Medical School, Centenary Hospital for Women and Children, Canberra Hospital, PO Box 11, Garran, Canberra, ACT, Woden ACT 2606, Australia.
World journal of pediatrics : WJP
|June 27, 2025
概括
在早产婴儿的慢性肺病 (PNCSCLD) 中,产后皮质类固醇的使用在11年内增加,并且与中度至重度功能残疾 (MSFD) 的更高率有关. 临床医生应谨慎使用PNCSCLD.
科学领域:
- 新生儿科学 新生儿科学
- 儿科肺病学 儿科肺病学
- 发育儿科 发育儿科
背景情况:
- 在早产婴儿的慢性肺病 (PNCSCLD) 中使用产后皮质类固醇具有复杂的风险-益处概况.
- 这项研究涉及PNCSCLD具有争议性的性质及其对婴儿神经发育的影响.
- 调查PNCSCLD的趋势和结果对于临床实践指南至关重要.
研究的目的:
- 检查在早产婴儿中使用PNCSCLD的11年趋势.
- 分析PNCSCLD和神经发育结果在18-42个月校正年龄之间的关联.
- 为在新生儿重症监护中关于PNCSCLD的临床决策提供信息.
主要方法:
- 基于人口的回顾性队列研究,利用来自十个新生儿重症监护病房的数据.
- 纳入标准:早产婴儿 (妊娠29周以下),出生于2007-2017年间,在出院时还活着,没有重大先天性异常.
- 18-42个月的神经发育评估对婴儿和没有PNCSCLD暴露的婴儿进行了年龄校正.
主要成果:
- 在11年的时间里,4258名符合条件的婴儿中有14.3%接受了PNCSCLD.
- 使用PNCSCLD的发病率从2007年的12.4%上升到2017年的19.6%.
- PNCSCLD与中度至重度功能障碍 (MSFD) 的几率比率增加显著相关 (OR=1.252,P≤0.001).
结论:
- 增加PNCSCLD的使用与早产婴儿中MSFD的更高发病率相关.
- 这些发现突显出PNCSCLD与神经发育不良结果之间存在着令人担忧的联系.
- 由于潜在的风险,建议临床医生在考虑为早产婴儿使用PNCSCLD时谨慎.
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