产前应用地塞米松对早产儿生长及智能发育的影响

目的探讨孕妇产前使用地塞米松对早产儿近、远期生长及智能发育的影响。方法选择2010年1月至2012年1月,在本院产科病房收治的孕28~34周早产分娩病例,根据产前是否使用过地塞米松分为观察组(116例)和对照组(215例),回顾性分析两组孕产妇的分娩结局,并对其所产早产婴儿的生长发育情况进行跟踪随访。结果在331例早产孕妇中,两组1 min Apgar评分差异无统计学意义,但观察组5 min Apgar评分情况明显高于对照组(P0.05);观察组早产儿呼吸窘迫综合征发生率及早产儿死亡率明显低于对照组,差异有统计学意义(P0.05);两组早产儿1岁时的体重、身高、头围等生长发育指标差异无统计学意义;采用Gesell量表对两组儿童进行智力发育测评亦未发现明显差异。结论产前地塞米松可显著降低严重出生窒息及早产儿RDS与死亡的发生;产前应用地塞米松对早产儿的近、远期大脑发育及体格发育无明显不良影响。

Influence of dexamethasone on physical and brain development of preterm infants

Objective To explore the effect of dexamethasone on physical and brain development in preterm infants. Methods 331 premature infants,delivered in 28-34 gestational weeks from January 2010 to January 2012 in our obstetrical department, were enrolled in this study. These infants were divided into 2 groups by antenatal exposure of dexamethasone： 116 cases in observation group and 215 eases in control group. The delivery outcomes of these cases were analyzed retrospectively. The developments of infants were followed up. Results In these 331 cases, the neonatal 1 min Apgar score were no significant difference between the two groups. However, the neonatal 5 min Apgar score were much higher in the observation group than the control group（P〈0.05）. In the observation group, the incidence of respiratory distress syndrome（RDS） and the neonatal mortality is significant lower than that of the control group（P〈0.05）. There were no significant differences in the index of infants＇ growth and development such as weight, height and head circumference between the two groups during the next 1 year follow up.The intelligence development of infants,evaluated by Gesell intelligent test showed no significant difference. Conclusions Antenatal dexamethasone can decrease severe birth asphyxia, RDS and mortality of preterm infants significantly.There were no obvious short-term or long-term adverse effects found in physical and brain development of preterm infant exposure to dexamethasone.