中国循证儿科杂志2018，Vol.13Issue(2)：88-92,5.DOI:10.3969/j.issn.1673-5501.2018.02.002
产前应用糖皮质激素预防足月择期剖宫产儿呼吸窘迫综合征系统评价和Meta分析
Antenatal glucocorticoids for reducing neonatal respiratory distress syndrome after full-term elective cesarean section :a systematic review and meta-analysis
摘要
Abstract
Objective To assess the efficacy and safety of antenatal glucocorticoids for reducing neonatal respiratory distress syndrome after full-term(more than 37 weeks) elective caesarean section.Methods Databases including PubMed,Embase,The Cochrane Library,ClinicalTrials.gov,CBM,WanFang Data,CNKI and VIP were searched to collect randomized controlled trials (RCTs) about prenatal glucocorticoids for preventing neonatal respiratory distress syndrome(RDS) after full-term elective cesarean section.Before delivery,experimental groups were treated with glucocorticoids (the type,dose,route of administration and course of treatment of drugs were not limited),and control groups were given a placebo or a blank control.We used the combination of subject headings and text words to search,all databases were searched from inception to April 19,2018.The primary outcomes were the incidence of neonatal RDS and neonatal mortality,the second outcomes were the incidence of transient tachypnea of newborn (TTN),neonatal respiratory distress,admitted to NICU with respiratory distress,neonatal sepsis,maternal infection and adverse reactions.The RCT bias risk assessment tool recommended by the Cochrane Handbook was used to evaluate the bias risk of the included literatures.Then meta-analysis was conducted by RevMan 5.3 software.Results A total of 4 RCTs papers,involving 3 893 singleton neonates were included.The overall quality of the 4 literatures was moderate.Meta-analysis showed that the incidence of RDS between the experimental group and control group was statistically significant difference (OR =0.45,95％CI:0.24-0.83),no significant difference between the two groups were shown on neonatal mortality.There were significant differences in the incidence of TTN (OR =0.41,95％ CI:0.29-0.59),admitted to NICU with respiratory distress (OR =0.42,95％ CI:0.29-0.63),neonatal respiratory distress (OR =0.34,95％ CI:0.22-0.53).One article reported the incidence of neonatal sepsis and maternal infection between the two groups,and there was no significant differences.Mothers of the treatment groups had a low adverse reaction rate.Conclusion Based on current clinical evidence,a course of antenatal glucocorticoids could be given to decrease the risk of neonatal RDS after term singleton elective cesarean section.关键词
糖皮质激素类/剖宫产术/婴儿/新生/呼吸窘迫综合征Key words
Glucocorticoids/Cesarean section/Infant, newborn/Respiratory distress syndrome引用本文复制引用
江开平,朱晓丹,董文斌,雷小平..产前应用糖皮质激素预防足月择期剖宫产儿呼吸窘迫综合征系统评价和Meta分析[J].中国循证儿科杂志,2018,13(2):88-92,5.基金项目
国家自然科学基金面上项目:81571480 （）
