产前糖皮质激素对糖尿病母亲的晚期早产儿结局的影响

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (292 KB) HTML (25 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨糖尿病母亲晚期早产儿产前糖皮质激素的使用模式,及产前糖皮质激素对糖尿病母亲晚期早产儿结局的影响。方法回顾性分析2016年1月至2021年12月本院产科分娩的631例单胎晚期早产儿及其母亲病例资料,根据母亲是否合并糖尿病分为糖尿病母亲组和非糖尿病母亲组,比较两组早产儿产前糖皮质激素的使用率。进一步将糖尿病母亲的晚期早产儿根据产前是否使用糖皮质激素分为激素组和对照组,比较两组早产儿呼吸系统疾病及低血糖的发生率等情况。结果 631例晚期早产儿中,糖尿病母亲的早产儿有183例,非糖尿病母亲组448例。糖尿病母亲组的晚期早产儿产前激素使用率为37.2%,非糖尿病母亲组的晚期早产儿产前糖皮质激素使用率27.0 %,两者差异有统计学意义。胎龄35周的糖尿病母亲的晚期早产儿,激素组早产儿胎龄显著低于对照组(P=0.026)。无论胎龄大小,与对照组相比,激素组糖尿病母亲的晚期早产儿,呼吸系统疾病的发生率及呼吸支持的使用率组间差异均无统计学意义,且两组间早产儿低血糖的发生率也无显著差异。结论在晚期早产儿中,糖尿病母亲的产前糖皮质激素的使用模式与非糖尿病母亲不同。产前糖皮质激素使用并未减少糖尿病母亲的晚期早产儿呼吸系统疾病的发生及呼吸支持的使用,也未增加低血糖的发生。产前糖皮质激素在糖尿病母亲的晚期早产儿中的使用尚需进一步研究。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	曹丽芳
	王慧
	张雪峰

关键词 ：产前糖皮质激素, 晚期早产儿, 糖尿病, 呼吸系统疾病, 低血糖

收稿日期: 2022-09-20

ZTFLH:	R17
	R72

通讯作者: 张雪峰(doctor1966@sina.com)

引用本文:

曹丽芳, 王慧, 张雪峰. 产前糖皮质激素对糖尿病母亲的晚期早产儿结局的影响[J]. 中国生育健康杂志, 2023, 34(6): 543-546.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2023/V34/I6/543

1 Roberts D,Brown J,Medley N,et al.Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth.Cochrane Database Syst Rev,2017,3:CD004454.
2 Reddy UM,Deshmukh U,Dude A,et al.Society for Maternal-Fetal Medicine Consult Series #58:Use of antenatal corticosteroids for individuals at risk for late preterm delivery:Replaces SMFM Statement #4,Implementation of the use of antenatal corticosteroids in the late preterm birth period in women at risk for preterm delivery.Am J Obstet Gynecol,2021 225:B36-B42.
3 Gyamfi-Bannerman C,Thom EA,Blackwell SC,et al.Antenatal Betamethasone for Women at Risk for Late Preterm Delivery.N Engl J Med,2016,374:1311-1320.
4 Amiya RM,Mlunde LB,Ota E,et al.Antenatal Corticosteroids for Reducing Adverse Maternal and Child Outcomes in Special Populations of Women at Risk of Imminent Preterm Birth:A Systematic Review and Meta-Analysis.PLoS One,2016,11:e0147604.
5 Battarbee AN,Clapp MA,Boggess KA,et al.Practice Variation in Antenatal Steroid Administration for Anticipated Late Preterm Birth:A Physician Survey.Am J Perinatol,2019,36:200-204.
6 中国医师协会新生儿科医师分会,《中华围产医学杂志》编辑委员会.早产儿呼吸窘迫综合征早期防治专家共识.中华围产医学杂志,2017,20:557-559.
7 中华医学会妇产科学分会产科学组.早产临床诊断与治疗指南.中华妇产科杂志,2014,49:481-484.
8 邵肖梅,叶鸿瑁,丘小汕.实用新生儿学.第5版.北京:人民卫生出版社,2018.
9 Fung GP,Chan LM,Ho YC,et al.Does gestational diabetes mellitus affect respiratory outcome in late-preterm infants.Early Hum Dev,2014,90:527-530.
10 Azad MB,Moyce BL,Guillemette L,et al.Diabetes in pregnancy and lung health in offspring:developmental origins of respiratory disease.Paediatr Respir Rev,2017,21:19-26.
11 Metzger BE,Persson B,Lowe LP,et al.Hyperglycemia and adverse pregnancy outcome study:neonatal glycemia.Pediatrics,2010,126:e1545-1552.
12 Dude AM,Yee LM,Henricks A,et al.Neonatal hypoglycemia after antenatal late preterm steroids in individuals with diabetes.J Perinatol,2021,41:2749-2753.
13 Battarbee AN,Sandoval G,Grobman WA,et al.Antenatal Corticosteroids and Preterm Neonatal Morbidity and Mortality among Women with and without Diabetes in Pregnancy.Am J Perinatol,2022,39:67-74.
14 Gyamfi-Bannerman C,Gilbert S,Landon MB,et al.Effect of antenatal corticosteroids on respiratory morbidity in singletons after late-preterm birth.Obstet Gynecol,2012,119:555-559.
15 Committee Opinion No.713:Antenatal Corticosteroid Therapy for Fetal Maturation.Obstet Gynecol,2017,130:e102-e109.
16 Deshmukh M,Patole S.Antenatal corticosteroids for impending late preterm (34-36+6 weeks) deliveries-A systematic review and meta-analysis of RCTs.PLoS One,2021,16:e0248774.
17 Ali H,Salama H,Robertson N,et al.Antenatal corticosteroids and short-term neonatal outcomes in term and near-term infants of diabetic mothers.Analysis of the Qatar PEARL-peristat registry.J Perinat Med,2021,49:377-382.
18 Räikkönen K,Gissler M,Kajantie E.Associations Between Maternal Antenatal Corticosteroid Treatment and Mental and Behavioral Disorders in Children.JAMA,2020,323:1924-1933.
19 Shah R,Harding J,Brown J,et al.Neonatal Glycaemia and Neurodevelopmental Outcomes:A Systematic Review and Meta-Analysis.Neonatology,2019,115:116-126.
20 王慧,付佳慧,曹丽芳,等.晚期早产儿低血糖与产前糖皮质激素的相关性研究.中国生育健康杂志,2022,33:166-168,171.