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Abstract：
OBJECTIVE: To assess the effect of prophylactic corticosteroids administration at 37 weeks before term elective cesarean section (CS) in reducing neonatal respiratory morbidity and admission to neonatal intensive care unit (NICU).
METHODS: This randomized trial was conducted focusing on women subjected to term elective CS. Women who were eligible for the study were divided into two groups. At 37 weeks\' gestation; study group received two intramuscular doses of 12 mg dexamethasone 24 h apart, while the control group given the usual care without steroids. Outcome measures were adverse neonatal respiratory outcomes (respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN)) and rates of admission to NICU.
RESULTS: Neonates in the treatment group had lower overall incidence of respiratory distress morbidity 7.9% versus 23% when compared to the control group. The main morbidity was TTN (7% in study versus 19.6% in control group). There was significantly lower incidence of both mild and moderate degrees of respiratory distress in the study group (7 and 0.9%, respectively) compared to 17 and 5.3% in the control group. The most significant benefit of steroid administration was noted in those babies 37-37(+6) weeks.
CONCLUSIONS: Antenatal administration of steroids at 37 weeks appears to be beneficial in reducing neonatal respiratory morbidity in women undergoing elective term CS.
METHODS: This randomized trial was conducted focusing on women subjected to term elective CS. Women who were eligible for the study were divided into two groups. At 37 weeks\' gestation; study group received two intramuscular doses of 12 mg dexamethasone 24 h apart, while the control group given the usual care without steroids. Outcome measures were adverse neonatal respiratory outcomes (respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN)) and rates of admission to NICU.
RESULTS: Neonates in the treatment group had lower overall incidence of respiratory distress morbidity 7.9% versus 23% when compared to the control group. The main morbidity was TTN (7% in study versus 19.6% in control group). There was significantly lower incidence of both mild and moderate degrees of respiratory distress in the study group (7 and 0.9%, respectively) compared to 17 and 5.3% in the control group. The most significant benefit of steroid administration was noted in those babies 37-37(+6) weeks.
CONCLUSIONS: Antenatal administration of steroids at 37 weeks appears to be beneficial in reducing neonatal respiratory morbidity in women undergoing elective term CS.
摘要：
目的：评估足月择期剖宫产（CS）前37周预防性使用糖皮质激素对降低新生儿呼吸道发病率和新生儿重症监护病房（NICU）入院的影响。
方法：这项随机试验的重点是接受足月选择性CS的女性。符合研究条件的妇女被分为两组。在妊娠37周时；研究组在24小时间隔接受两次肌内剂量的12mg地塞米松，而对照组给予常规护理，不使用类固醇。结果指标包括不良的新生儿呼吸结局（呼吸窘迫综合征（RDS）和新生儿短暂性呼吸急促（TTN））以及NICU的入院率。
结果：与对照组相比，治疗组新生儿呼吸窘迫的总发生率为7.9%，低于23%。主要发病率为TTN（研究组为7％，对照组为19.6％）。研究组轻度和中度呼吸窘迫的发生率均显着降低（7％和0.9％，分别）与对照组的17％和5.3％相比。在37-37(+6)周的婴儿中注意到类固醇给药的最显著益处。
结论：在接受择期CS的妇女中，37周产前给予类固醇似乎有利于降低新生儿呼吸道发病率。
方法：这项随机试验的重点是接受足月选择性CS的女性。符合研究条件的妇女被分为两组。在妊娠37周时；研究组在24小时间隔接受两次肌内剂量的12mg地塞米松，而对照组给予常规护理，不使用类固醇。结果指标包括不良的新生儿呼吸结局（呼吸窘迫综合征（RDS）和新生儿短暂性呼吸急促（TTN））以及NICU的入院率。
结果：与对照组相比，治疗组新生儿呼吸窘迫的总发生率为7.9%，低于23%。主要发病率为TTN（研究组为7％，对照组为19.6％）。研究组轻度和中度呼吸窘迫的发生率均显着降低（7％和0.9％，分别）与对照组的17％和5.3％相比。在37-37(+6)周的婴儿中注意到类固醇给药的最显著益处。
结论：在接受择期CS的妇女中，37周产前给予类固醇似乎有利于降低新生儿呼吸道发病率。
