出生前反复注射皮质类固醇后新生儿的肾上腺功能:一项随机对照试验

来源 :世界核心医学期刊文摘(妇产科学分册) | 被引量 : 0次 | 上传用户:alfred0612
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Objective: Do repeat prenatal corticosteroids suppress neonatal cortisol concentrations Study design: Randomized controlled trial of women given weekly repeat corticosteroids or saline placebo,while at risk of preterm birth, until 32 weeks’ gestation. Results: Cord serum cortisol concentrations in infants exposed to repeat corticosteroids were similar compared with infants exposed to a single course of corticosteroids (mean difference - 26 nmol/L, 95% CI- 57, 5 nmol/L, P = .10), as were prestress salivary cortisol concentrations on day 3 (median 16.5 vs 15.3 nmol/L, P = .96). The adrenal response to a stressor on day 3 was lower in the repeat corticosteroid group compared with the single course group (median 11.9 vs 21.4 nmol/L, P = .02). Cortisol concentrations were lower in the repeat corticosteroid group on day 7 (median 11.7 vs 18.2 nmol/L, P = .04), but not on days 14 and 21. Conclusion: The short or long- term clinical impact, if any, of these changes in adrenal function needs to be dete. rmined. Objective: Do repeat prenatal corticosteroids suppress neonatal cortisol concentrations Study design: Randomized controlled trial of women given weekly weekly repeat corticosteroids or saline placebo, while at risk of preterm birth, until 32 weeks’ gestation. Results: Cord serum cortisol concentrations in infants exposed to repeat corticosteroids were similar compared with infants exposed to a single course of corticosteroids (mean difference - 26 nmol / L, 95% CI- 57, 5 nmol / L, P = .10), as were prestress salivary cortisol concentrations on day 3 16.5 vs 15.3 nmol / L, P = .96). The adrenal response to a stressor on day 3 was lower in the repeat corticosteroid group compared with the single course group (median 11.9 vs 21.4 nmol / L, P = .02). Cortisol concentrations were lower in the repeat corticosteroid group on day 7 (median 11.7 vs 18.2 nmol / L, P = .04), but not on days 14 and 21. Conclusion: The short or long- term clinical impact, if any, of these changes in adrenal function needs to be dete. rmined.
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