Effects of antenatal corticosteroid administration on mortality and long-term morbidity in early preterm, growth-restricted infants
Effects of antenatal corticosteroid administration on mortality and long-term morbidity in early preterm, growth-restricted infants
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DOI：
10.1016/s0029-7844(01)01343-6
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发表时间：
2001-06-01
影响因子：
7.2
通讯作者：
Treffers, PE
中科院分区：
文献类型：
--
作者：
Schaap, AH;Wolf, H;Treffers, PE
目的：评估产前皮质类固醇对早期早产、生长受限婴儿的死亡率、发病率和残疾率的影响。方法：这项在两个三级保健中心进行的病例对照研究包括所有因胎盘功能不全而生长受限的活产单胎婴儿，在胎龄26- 28岁的分娩前，因心脏分娩图显示胎儿窘迫而剖腹产的患者，1984年至1991年期间为32周。在出生前24小时以上和出生前7天内接受过皮质类固醇治疗的婴儿与母亲在分娩前24小时以上入院但未接受过皮质类固醇治疗的婴儿在出生体重、性别和出生年份方面相匹配。主要的结局指标是在2岁矫正年龄时无残疾或残疾的生存率。60个病例对照对的样本将提供81%的把握度来证明皮质类固醇治疗使该结局增加50%[比值比（OR）3.0]。结果：研究组和对照组各62例，采用问卷调查法对两组儿童学龄期行为和体格发育进行评价。2岁校正年龄时无残疾或残疾的生存率在皮质类固醇组中更常见[OR 3.2置信区间（CI）1.1，11.2]。在学龄期的长期随访中，对身体生长有统计学显著的负面影响（OR 5.1，CI 1.4，23.8），但在行为上没有差异detected.Conclusion：从产前皮质类固醇的早期早产儿，生长受限的婴儿的好处似乎超过可能的不良影响。（妇产科2001;97：954-60。(C)2001年由美国妇产科医师学会出版）。
Objective: To evaluate the effect of antenatal corticosteroids on mortality, morbidity, and disability or handicap rate in early preterm, growth-restricted infants.Methods: This case-control study in two tertiary care centers included all live-born singleton infants with growth-restriction due to placental insufficiency, who were delivered by cesarean because of cardiotocographic signs of fetal distress before the beginning of labor at a gestational age of 26-32 weeks during the years 1984-1991. Infants who had been treated antenatally with corticosteroids more than 24 hours and less than 7 days before birth were matched by birth weight, sex, and year of birth with infants whose mothers had been admitted more than 24 hours before delivery but were not treated antenatally with steroids. The main outcome measure was survival without disability or handicap at 2 years corrected age. A sample of 60 case-control pairs would give 81% power to demonstrate 50% increase of this outcome [odds ratio (OR) 3.0] by corticosteroid treatment. Behavior and physical growth were evaluated at school age by questionnaire.Results: The study group and control group consisted of 62 infants each. Survival without disability or handicap at 2 years' corrected age was more frequent in the corticosteroid group [OR 3.2 confidence interval (CI) 1.1, 11.2]. In the long-term follow-up at school age there was a statistically significant negative effect on physical growth (OR 5.1, CI 1.4, 23.8), but no differences in behavior were detected.Conclusion: Benefits from antenatal corticosteroids for early preterm, growth-restricted infants appear to outweigh possible adverse effects. (Obstet Gynecol 2001;97:954-60. (C) 2001 by The American College of Obstetricians and Gynecologists.).