Maternal Glucocorticoid in Unplanned Premature Labor. Controlled Study on the Effects of Betamethasone Phosphate on the Phospholipids of the Gastric Aspirate and on the Adrenal Cortical Function of the Newborn Infant
Maternal Glucocorticoid in Unplanned Premature Labor. Controlled Study on the Effects of Betamethasone Phosphate on the Phospholipids of the Gastric Aspirate and on the Adrenal Cortical Function of the Newborn Infant
复制标题
非计划早产中的母体糖皮质激素。
作者：
K. Teramo;M. Hallman;K. Raivio
总结：在一项双盲研究中，比较了倍他米松与安慰剂对表面活性成分和新生儿肾上腺功能的影响，该研究包括74例有早产风险的患者。呼吸窘迫综合征的总体发生率较低，并且在betterfly和安慰剂组之间没有观察到差异。betabetrin组和安慰剂组新生儿胃吸出物的磷脂模式（卵磷脂/鞘磷脂比、丙酮沉淀卵磷脂、磷脂酰肌醇/鞘磷脂比和磷脂酰甘油/鞘磷脂比）相似，表明肺表面活性物质相似。新生儿肾上腺皮质的反应性，在24小时的年龄进行了2小时促肾上腺皮质激素试验，并没有显着差异的婴儿的母亲接受倍他米松或安慰剂。倍他米松组和安慰剂组呼吸窘迫综合征的低发生率部分归因于胎膜长时间破裂的高发生率。我们的研究结果并不排除的可能性，产前母亲管理betterfly可以防止呼吸窘迫综合征在其他定义的高危infants.Speculation：母亲betterfly管理并没有提高胎儿肺成熟的加速在“胎儿压力”由于胎膜破裂，即使肺流出物的磷脂有些不成熟。磷酸倍他米松仅短暂抑制胎儿肾上腺功能。由于潜在的长期副作用，糖皮质激素的使用应限于发生呼吸窘迫综合征的风险较高且预计不会自发加速肺成熟的病例。
Summary: The effects of betamethasone on surfactant composition and neonatal adrenal function were compared with placebo in a double-blind study, which included 74 patients at risk for premature delivery. The overall incidence of respiratory distress syndrome was low, and no difference was observed between the betamethasone and placebo groups. The phospholipid pattern (lecithin/sphingomyellin ratio, acetone precipitated lecithin, phosphatidylinositol/sphingomyelin ratio, and phosphatidylglycerol/sphingomyelin ratio) from gastric aspirates of newborn infants was similar in the betamethasone and placebo groups, suggesting a similarity in lung surfactant. The responsiveness of the adrenal cortex of the newborn infants, evaluated by a 2-hr adrenocorticotropic hormone test at the age of 24 hr, did not differ between infants whose mothers had received either betamethasone or placebo. The low incidence of respiratory distress syndrome in the betamethasone and placebo groups was ascribed in part to a high incidence of prolonged rupture of fetal membranes. Our results do not exclude the possibility that antenatal maternal administration of betamethasone could prevent respiratory distress syndrome in other defined high-risk infants.Speculation: Maternal betamethasone administration does not enhance the acceleration of the fetal lung maturation in "fetal stress" due to rupture of fetal membranes, even if the phospholipids of the lung effluent are somewhat immature. Betamethasone phosphate only transiently suppresses fetal adrenal function. Due to the potential long-term side effects, the use of glucocorticoids should be limited to cases in which the risk to develop respiratory distress syndrome is high and spontaneous acceleration of lung maturation is not expected.