JAMA Pediatr:分娩前激素治疗可降低早产儿不良事件风险

2017-05-16 zhangfan MedSci原创

产前激素疗法可显著降低早产儿的死亡及不良后果风险,这种治疗在产前几小时进行即可受益

临床中发现产前激素(ANS)的使用到分娩完成的时间间隔变化较大,造成这种变化的因素尚不清楚。近日研究人员就ANS使用时机与早产儿存活率之间的关系进行研究。

这项名为EPICE的研究是基于人群的前瞻性研究,11个欧洲国家的19个地区参与。研究从2011年至2012年间进行,有4594名24至31周的早产儿参与。研究统计首次激素注射至分娩的时间间隔。主要终点包括:住院死亡率;复合死亡率或严重新生儿病发病率,包括3级及以上的脑出血、囊性脑栓塞室、坏死性小肠结肠炎和3级及以上的早产儿视网膜病变;严重的颅脑损伤。

参与研究的婴儿中,2496名男婴(54.3%),平均月龄28.5周,平均体重1213g。共有662名早产儿死亡,未接受ANS的婴儿死亡率为20.6%(136例)。ANS可立即和快速的下调死亡率,在出生前18-36小时注射激素可减少50%的早产儿死亡风险。复合死亡率以及严重新生儿病发病率结果类似,但发现越早进行激素治疗,严重的新生儿脑损伤风险越低(48小时以上),但研究发现ANS与各种风险降低之间的关系是短暂的,间隔超过1周后,早产儿严重脑损伤风险提高。在假设ANS时机与死亡率为因果关系的前提下,与对照相比,产前3小时进行激素治疗可降低早产儿26%的死亡风险。

研究认为,产前激素疗法可显著降低早产儿的死亡及不良后果风险,这种治疗在产前几小时进行即可受益。

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    2017-09-29 feather89
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    2017-05-18 linlin2312
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    2017-05-16 jiuling

    学习了谢谢分享

    0

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    2017-05-16 135****7952平儿

    学习了

    0

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    2017-05-16 ideal肿瘤医

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