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在整个童年期间产前皮质类固醇和传染病
Fabienne Decrue1, Emily M Frier2, Chun Lin1
1Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
产前皮质类固醇 (ACS) 会增加满期婴儿的感染风险,但不会增加34周前出生的早产婴儿的感染风险. 为了减轻不良影响,需要更精确的ACS管理指南.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿研究新生儿研究
- 儿童传染病 儿童传染病
背景情况:
- 国际指导方针建议在34周怀孕前使用产前皮质类固醇 (ACS) 治疗那些有早产风险的孕妇.
- ACS暴露对儿童和成人感染易感性的长期影响在很大程度上是未知的.
研究的目的:
- 调查产前皮质类固醇 (ACS) 暴露与儿童呼吸道和非呼吸道感染风险之间的关联.
- 为了比较不同妊娠年龄出生于ACS暴露和未暴露的儿童之间的感染易感性.
主要方法:
- 基于人口的队列研究,使用芬兰和苏格兰的全国性注册表 (怀孕治疗研究联盟).
- 包括1997-2018年 (芬兰) 和2006-2018年 (苏格兰) 之间的单独出生,追踪到2018年.
- 结果包括呼吸道或非呼吸道感染的首次诊断,按出生时的妊娠年龄分层.
主要成果:
- ACS暴露与在满期 (37-41周) 和晚期早产 (34-36周) 出生的儿童中增加呼吸道和非呼吸道感染的风险有关.
- 在非常早产婴儿 (孕期<34周出生) 中,ACS暴露和感染风险之间没有显著的关联.
- 与未暴露儿童相比,暴露于ACS的儿童感染的发病率更高.
结论:
- 产前皮质类固醇 (ACS) 暴露与21岁之前的满期儿童感染的风险更高有关.
- 在34周妊娠前暴露于ACS的早产婴儿中,没有发现感染风险增加.
- 更严格的ACS管理标准和更好的早产预测是必要的,以尽量减少潜在的不良影响.
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