{"title":"早期暴露于低剂量氢化可的松的极早产儿自发性肠穿孔。","authors":"Gilles Cambonie, Anais Jouffrey, Benoit Tessier, Clémentine Combes, Angelo Polito, Arthur Gavotto","doi":"10.1111/apa.70175","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To assess the occurrence of spontaneous intestinal perforation (SIP) in < 28 weeks' gestational age (GA) infants exposed to early low-dose hydrocortisone (ELH) to reduce the risk of bronchopulmonary dysplasia (BPD). Additionally, the risk of SIP was assessed in infants exposed to early concomitant treatment with ibuprofen for persistent ductus arteriosus (PDA).</p><p><strong>Methods: </strong>Observational study in a tertiary neonatal centre preceding and following hydrocortisone implementation. Exposed and non-exposed infants were compared after matching on delivery mode, multiple pregnancy, GA, birthweight, sex and using multivariate logistic regression analysis.</p><p><strong>Results: </strong>Among 653 infants, 259 (40%) had been exposed to hydrocortisone, and 210 from each group could be paired. Exposed infants had a higher rate of SIP (8.1% vs. 2.9%, OR [95% CI] 2.99 [1.15-7.74]). Early ibuprofen was provided to 110 exposed (52%) and 105 nonexposed (50%). The rate of SIP was higher in exposed infants cotreated with ibuprofen (11.8% vs. 3.8%, OR 3.38 [1.07-10.73]). Logistic regression analysis in the whole cohort confirmed the risk of SIP in infants exposed to concomitant treatment (OR [95% CI] 2.93 [1.24-6.93]).</p><p><strong>Conclusion: </strong>Early concomitant treatment with ELH and ibuprofen is associated with an increased risk of SIP in infants born < 28 weeks.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Spontaneous Intestinal Perforation in Extremely Premature Infants Exposed to Early Low-Dose Hydrocortisone.\",\"authors\":\"Gilles Cambonie, Anais Jouffrey, Benoit Tessier, Clémentine Combes, Angelo Polito, Arthur Gavotto\",\"doi\":\"10.1111/apa.70175\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To assess the occurrence of spontaneous intestinal perforation (SIP) in < 28 weeks' gestational age (GA) infants exposed to early low-dose hydrocortisone (ELH) to reduce the risk of bronchopulmonary dysplasia (BPD). Additionally, the risk of SIP was assessed in infants exposed to early concomitant treatment with ibuprofen for persistent ductus arteriosus (PDA).</p><p><strong>Methods: </strong>Observational study in a tertiary neonatal centre preceding and following hydrocortisone implementation. Exposed and non-exposed infants were compared after matching on delivery mode, multiple pregnancy, GA, birthweight, sex and using multivariate logistic regression analysis.</p><p><strong>Results: </strong>Among 653 infants, 259 (40%) had been exposed to hydrocortisone, and 210 from each group could be paired. Exposed infants had a higher rate of SIP (8.1% vs. 2.9%, OR [95% CI] 2.99 [1.15-7.74]). Early ibuprofen was provided to 110 exposed (52%) and 105 nonexposed (50%). The rate of SIP was higher in exposed infants cotreated with ibuprofen (11.8% vs. 3.8%, OR 3.38 [1.07-10.73]). Logistic regression analysis in the whole cohort confirmed the risk of SIP in infants exposed to concomitant treatment (OR [95% CI] 2.93 [1.24-6.93]).</p><p><strong>Conclusion: </strong>Early concomitant treatment with ELH and ibuprofen is associated with an increased risk of SIP in infants born < 28 weeks.</p>\",\"PeriodicalId\":55562,\"journal\":{\"name\":\"Acta Paediatrica\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-06-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Paediatrica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/apa.70175\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Paediatrica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/apa.70175","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
摘要
目的：评价自发性肠穿孔（SIP）发生的方法：观察性研究在三级新生儿中心前后氢化可的松实施。在分娩方式、多胎妊娠、GA、出生体重、性别匹配后，采用多因素logistic回归分析比较暴露婴儿和未暴露婴儿。结果：653例婴儿中，259例（40%）暴露于氢化可的松，每组210例可配对。暴露婴儿的SIP发生率较高（8.1% vs. 2.9%, OR [95% CI] 2.99[1.15-7.74]）。给暴露者110例（52%）和未暴露者105例（50%）提供早期布洛芬。与布洛芬一起治疗的暴露婴儿的SIP发生率更高（11.8%比3.8%,OR 3.38[1.07-10.73]）。整个队列的Logistic回归分析证实，暴露于联合治疗的婴儿发生SIP的风险（OR [95% CI] 2.93[1.24-6.93]）。结论：早期联合ELH和布洛芬治疗与新生儿SIP风险增加有关
Spontaneous Intestinal Perforation in Extremely Premature Infants Exposed to Early Low-Dose Hydrocortisone.
Aim: To assess the occurrence of spontaneous intestinal perforation (SIP) in < 28 weeks' gestational age (GA) infants exposed to early low-dose hydrocortisone (ELH) to reduce the risk of bronchopulmonary dysplasia (BPD). Additionally, the risk of SIP was assessed in infants exposed to early concomitant treatment with ibuprofen for persistent ductus arteriosus (PDA).
Methods: Observational study in a tertiary neonatal centre preceding and following hydrocortisone implementation. Exposed and non-exposed infants were compared after matching on delivery mode, multiple pregnancy, GA, birthweight, sex and using multivariate logistic regression analysis.
Results: Among 653 infants, 259 (40%) had been exposed to hydrocortisone, and 210 from each group could be paired. Exposed infants had a higher rate of SIP (8.1% vs. 2.9%, OR [95% CI] 2.99 [1.15-7.74]). Early ibuprofen was provided to 110 exposed (52%) and 105 nonexposed (50%). The rate of SIP was higher in exposed infants cotreated with ibuprofen (11.8% vs. 3.8%, OR 3.38 [1.07-10.73]). Logistic regression analysis in the whole cohort confirmed the risk of SIP in infants exposed to concomitant treatment (OR [95% CI] 2.93 [1.24-6.93]).
Conclusion: Early concomitant treatment with ELH and ibuprofen is associated with an increased risk of SIP in infants born < 28 weeks.
期刊介绍：
Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including:
neonatal medicine
developmental medicine
adolescent medicine
child health and environment
psychosomatic pediatrics
child health in developing countries
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