妊娠不足 34 周的早产儿 2 岁矫正后的神经发育结果与产前类固醇状况的关系

P. R. Jayakumar, P. S. Sukumaran
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摘要

研究目的本研究旨在确定妊娠期小于 34 周、等于或大于 25 周的早产儿在 2 岁矫正期的神经发育状况与他们的产前类固醇状况之间的关系。材料与方法:这项人群水平的前瞻性研究于 2017 年至 2023 年在喀拉拉邦中部进行,为期 6 年。出生时胎龄小于 34 周、等于或大于 25 周的早产儿在产后 3 个月内接受随访,被随机纳入研究。共对 150 名儿童进行了随访,并在他们两岁时使用贝利婴幼儿发育量表(Bayley Scales of Infant and Toddler Development edition-3)进行了神经发育评估。这项前瞻性观察研究于2017年9月22日获得喀拉拉邦科塔亚姆圣雄甘地大学行为科学学院机构伦理委员会的批准。结果:81名早产<34周的婴儿属于产前完全类固醇组,40名早产<34周的婴儿属于产前部分类固醇组,29名早产<34周的婴儿属于无类固醇组。与产前完全使用类固醇组和未使用类固醇组相比,产前小于34周的早产儿的神经发育状况总评分以及认知、语言、运动和社交情感发育领域评分均明显较高。结论产前类固醇对胎龄等于或大于 25 周和小于 34 周的早产儿在 2 岁矫正期的整体神经发育结果有重大影响,与未使用任何产前类固醇的胎龄等于或大于 25 周和小于 34 周的早产儿相比,使用完全产前类固醇组的早产儿获益最大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neurodevelopmental outcome of pre-term babies less than 34 weeks of gestation at corrected 2 years of age, with respect to their antenatal steroid status
Objectives: The objective of this study was to determine the neurodevelopmental status of pre-term babies between <34 weeks of gestation and equal to or more than 25 weeks of gestation, at corrected 2 years of age with respect to their antenatal steroid status. Materials and Methods: This population-level prospective study was conducted over a period of 6 years from 2017 to 2023 in middle Kerala. Pre-term babies with gestational age at birth between <34 weeks and equal to or more than 25 completed weeks, presenting for follow-up within 3 months of delivery, were randomly enrolled for the study. A total of 150 children were followed up and neurodevelopmental assessment done using Bayley Scales of Infant and Toddler Development edition-3 at their corrected 2 years of age. Approval for this prospective observational study was obtained from the Institutional Ethics Committee, School of Behavioral Sciences, Mahatma Gandhi University, Kottayam, Kerala, dated September 22, 2017. Results: Eighty-one pre-term <34 weeks babies belonged to the antenatal steroid complete group, 40 pre-term <34 weeks babies belonged to the antenatal steroid partial group, and 29 pre-term <34 weeks babies belonged to the nil steroid group. Total neurodevelopmental status score and domain-wise, cognitive, language, motor, and social-emotional developmental scores show significantly higher scores for pre-term <34 weeks with antenatal history of complete course steroid administered before pre-term delivery compared to partial and nil antenatal steroid group. Conclusions: Antenatal steroids are having a significant impact on the overall neurodevelopmental outcome of pre-term babies equal to or more than 25 weeks of gestation and <34 weeks of gestation, at their corrected 2 years of age, the maximum benefit for complete antenatal steroid group pre-term babies, equal to or more than 25 weeks and <34 completed weeks of gestation when compared with pre-term babies, equal to or more than 25 weeks and <34 completed weeks of gestation without any antenatal steroids.
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