产前应用糖皮质激素对超早产儿预后影响的研究进展

Advances in antenatal corticosteroids for improving perinatal outcomes of extremely preterm infants

20世纪90年代中期,产前糖皮质激素在超早产儿(<28周早产儿)中的应用超过60%,2005年以来,瑞典的出生胎龄23~24周早产儿生存率超过50%,胎龄≥25周的超早产儿死亡率在发达国家下降至13%~22%,这与产前应用糖皮质激素明显相关。国内尚缺乏代表性强的研究证据,用以研究现有条件下产前糖皮质激素对超早产儿预后的影响。本文就产前应用糖皮质激素对超早产儿预后影响的研究进展进行了综述,有助于从围产干预策略及质量评估等方面提高我国超早产儿救治水平。

Large population-based cohort studies conducted in the industrialized countries in different eras revealed that the use of antenatal corticosteroids for extremely preterm births(EPT,<28 gestational weeks)reached 60%or higher in the mid-1990s,accompanying by steadily declined perinatal mortality to 13%-22%in EPT with gestational age≥25 weeks in developed countries.Notably,the survival rate of EPT with 23-24 weeks of gestation was over 50%in Sweden since 2005.There's a link between the increment of antenatal corticosteroids use and steady decline of mortality in EPT in the past three decades.High-quality evidence is needed to demonstrate the impact of antenatal corticosteroids on EPT perinatal outcomes under the current healthcare background in China.This review,focusing on the progression of antenatal corticosteroid treatment for EPT,may facilitate the quality improvement of maternal-fetal and infant healthcare in China.