产前糖皮质激素末次给药时间对早期早产儿并发症的影响

Influence of the last administration time of antenatal glucocorticoids on complications of premature infants

目的 探讨产前末次糖皮质激素(ACS)给药至分娩间隔时间对早期早产儿主要并发症的影响。方法 回顾性分析2020年4月~2023年4月于潍坊市人民医院住院治疗的胎龄28周~33+6周早产儿300例,根据末次使用ACS至分娩的时间间隔,分为<48h组(n=105)、~7d组(n=141)和>7d组(n=54);比较3组患儿并发症发生情况;采用单因素Logistic回归分析胎龄对早期早产儿并发症的影响。结果 3组患儿胎龄、有创机械辅助通气使用率、新生儿呼吸窘迫综合征(NRDS)发生率有明显差异(P<0.05);新生儿坏死性小肠结肠炎(NEC)、支气管肺发育不良(BPD)、败血症、代谢性酸中毒的发生率无显著差异(P>0.05);单因素Logistic回归分析显示,胎龄是发生NRDS的独立危险因素。结论 单疗程ACS末次给药至分娩的间隔时间与早期早产儿NRDS发生率、有创机械通气使用率存在相关性,且间隔<48h是最佳用药时间窗,胎龄是NRDS发生的独立危险因素。

Objective To investigate the effect of the time interval from the last intramuscular injection of antenatal corticosteroids(ACS)administration to delivery on the main complications of preterm infants.Methods A ret-rospective analysis of 300 premature infants hospitaled in the Neonatal Intensive Care Unit of Weifang People's Hospital from April 2020~April 2023 with a gestational age of 28 weeks to 33+6 weeks was performed.The time interval from glu-cocorticoid to delivery was divided into<48h group(105 cases),~7 days group(141 cases)and>7 days group(54 ca-ses).The major complications were compared among the three groups.Univariate Logistic regression was used to analyze the effect of gestational age on major complications of preterm infants.Results There were significant differences in ges-tational age and the rate of invasive mechanical ventilation among the three groups,and there were significant differences between the two groups.The incidence of neonatal respiratory distress syndrome(NRDS)was significantly different a-mong the three groups,and the two groups were significantly different.There were significant differences between the two comparisons(P<0.05),and there were no significant difference in the incidence of other clinical complications,inclu-ding Necrotizing Enterocolitis(NEC),Bronchopulmonary Dysplasia(BPD),sepsis,and metabolic acidosis(P>0.05).Univariate Logistic regression analysis showed that the gestational age was an independent risk factor for NRDS.Conclusion The time interval from the last administration of ACS to delivery in a single course is correlated with the incidence of NRDS and the use rate of mechanical ventilation in premature infants.The interval from ACS to delivery<48 hours is the optimal time window for medication,and gestational age is an independent risk factor for the occurrence of NRDS.