晚期早产产前糖皮质激素应用的证据和争议

Antenatal corticosteroid therapy in late preterm infants:evidence and controversies

晚期早产儿是指出生胎龄34+0~36周+6的早产儿;相较于足月儿,晚期早产儿有更高的新生儿呼吸系统疾病发生率。产前糖皮质激素应用是促进胎肺成熟、改善早产儿预后的重要产前干预措施,在早期早产、中期早产中推荐常规使用。但晚期早产产前糖皮质激素的应用目前仍存在较大争议。本文通过对产前糖皮质激素应用的药物学基础、临床研究证据、指南推荐、使用争议及可能的并发症、未来研究方向等几个方面进行综述,以期为临床实践提供参考。

Compared with term infants,late preterm infants,defined as the gestational age of 34+0-36+6 weeks,have a significantly higher incidence of neonatal respiratory diseases.Antenatal corticosteroid(ACS)therapy is of great importance in promoting lung maturation and improving prognosis in preterm infants.It has been recommended as a routine approach in the treatment of preterm infants less than 34 gestational weeks.However,its efficacy and potential side effects in late preterm infants remain inconclusive.We review the pharmaceutical mechanisms,clinical research data,current guidelines,controversies,potential complications of ACS therapy in late preterm birth to inform current clinical practice and address future research directions.