产前糖皮质激素促进胎儿肺成熟及其对母子的影响

Antenatal glucocorticoids for accelerating fetal lung maturation and its effects on parturients and offspring

产前糖皮质激素（GC）治疗能有效降低新生儿病死率和严重疾病的发生率，且不增加孕妇绒毛膜羊膜炎、子宫内膜炎及死亡风险，已成为改善新生儿预后最重要的产前干预措施之一。我国指南指出所有妊娠28～34^＋6周的先兆早产应当给予1个疗程的GC治疗，近年来研究表明，若临床需要，22～39周孕妇均可考虑使用GC。产前使用GC不增加子代神经系统发育障碍风险，但对子代的生殖系统及免疫功能等可能造成不良影响。现就产前使用GC的种类、途径、孕龄、最佳给药时间、特殊疗程、妊娠特殊情况下的使用及对母子的影响等方面研究进展进行综述。

Prenatal glucocorticoids（GC） therapy can effectively reduce neonatal mortality and the incidence of severe diseases without increasing the risk of chorioamnionitis, endometritis and maternal death, and it has become one of the most important prenatal interventions to improve neonatal prognosis.Chinese guideline points out that all pregnant women at risk of preterm birth between 28 to 34＋ 6 weeks should be treated with a courses of GC and recent studies show that it should also be considered at 22-39 weeks if the clinical needs.Prenatal use of GC does not increase the risk of developing nervous system disorders in offspring, however, the reproductive system and immune function of the offspring may have adverse effects.In this review, the GC type, approach, gestational age, the optimal time for medicine, course of special treatment, use under special pregnancy circumstances, influence on both mothers and infants and so on are summarized.