中国当代儿科杂志2024，Vol.26Issue(10)：1040-1045,6.DOI:10.7499/j.issn.1008-8830.2405073
孕母使用产前糖皮质激素对极早产儿结局及婴儿期神经发育的影响
Effects of antenatal corticosteroids on outcomes of very premature infants and neurodevelopment during infancy
摘要
Abstract
Objective To explore the effects of antenatal corticosteroids(ACS)on the outcomes of very premature infants(VPIs)and neurodevelopment during infancy.Methods A retrospective study was conducted on 190 VPIs admitted to the Department of Pediatrics of the First Affiliated Hospital of Anhui Medical University from January 2020 to December 2022.The infants were categorized into four groups based on ACS usage and dosage:no ACS group(n=18),single-course group(n=88),multi-course group(n=40),and partial-course group(n=44).The clinical outcomes,Neonatal Behavioral and Neurological Assessment(NBNA)scores at 40 weeks of corrected age,and Gesell Developmental Schedule(Gesell)scores at 1 year of corrected age were compared among the four groups.The impact of timing of ACS use on the Gesell scores of infants at 1 year of corrected age in VPIs with specific gestational ages was analyzed.Results The incidence rates of neonatal respiratory distress syndrome,bronchopulmonary dysplasia,transient tachypnea of the newborn,and neonatal pneumonia were significantly lower in the partial-course,single-course,and multiple-course groups compared with the no ACS group(P<0.008).However,there was no significant difference among the partial-course,single-course,and multiple-course groups(P>0.008).The NBNA scores(behavioral ability,active muscle tone,primitive reflexes,and general assessment)at 40 weeks of corrected age were significantly higher in the no ACS,partial-course,and single-course groups than in the multiple-course group(P<0.008).The proportion of VPIs with normal neurodevelopment at 1 year of corrected age was significantly higher in the no ACS,partial-course,and single-course groups than in the multiple-course group(P<0.008).The timing of ACS use had no significant effect on neurodevelopment at a corrected age of 1 year in infants with various gestational ages(P>0.05).Conclusions ACS is crucial for the development of the respiratory system in VPIs,but multiple courses of ACS may cause neurodevelopmental abnormalities.The impact of ACS use on neurodevelopment is independent of gestational age and the timing of ACS use.关键词
产前糖皮质激素/临床结局/神经发育/极早产儿Key words
Antenatal corticosteroid/Clinical outcome/Neurodevelopment/Very premature infant引用本文复制引用
陈智,李明,张丽丽,吴德..孕母使用产前糖皮质激素对极早产儿结局及婴儿期神经发育的影响[J].中国当代儿科杂志,2024,26(10):1040-1045,6.基金项目
安徽省临床医学研究科研项目(202204295107020007). （202204295107020007）
