Abstract：
OBJECTIVE: To compare the effects of an incomplete course and more than 1 course of dexamethasone, relative to a control of a single complete course, on foetal respiratory problems and other adverse outcomes of preterm birth.
METHODS: This was a retrospective chart review of 1800 women with preterm delivery. Data were collected on newborns whose mothers administered 1 full course of dexamethasone (916/1800; 50.9%), a partial course (716/1800; 39.8%) and more than 1 course (168/1800; 9.3%). Demographic data and adverse maternal and neonatal outcomes were recorded.
RESULTS: Preterm singleton newborns whose mothers received several steroid hormone courses were significantly more likely to have adverse outcomes than newborns of mothers given 1 course. The negative outcomes were the need for positive pressure ventilation ([aOR] 1.831; 95% CI, (1.185,2.829); P = 0.019), ventilator support ([aOR] 1.843; 95% CI, (1.187,2.861); P = 0.011), and phototherapy ([aOR] 1.997; 95% CI, (1.378,2.895); P < 0.001), transient tachypnoea of the newborn ([aOR] 1.801; 95% CI, (1.261,2.571); P = 0.002), intraventricular haemorrhage ([aOR] 2.215; 95% CI, (1.159, 4.233); P = 0.027), sepsis ([aOR] 1.737; 95% CI, (1.086, 2.777); P = 0.007), and admission to neonatal intensive care ([aOR] 1.822; 95% CI, (1.275,2.604); P = 0.001). In the group of very preterm infants, newborns of mothers administered an incomplete course had developed respiratory distress syndrome (RDS) ([aOR] 3.177; 95% CI, (1.485, 6.795); P = 0.006) and used ventilatory support ([aOR] 3.565; 95% CI, (1.912, 6.650); P < 0.001) more than those of mothers receiving a single course.
CONCLUSIONS: Preterm singleton newborns whose mothers were given multiple courses of dexamethasone had an increased incidence of RDS and other adverse outcomes than those of mothers receiving a full course. However, very preterm newborns whose mothers were administered 1 full dexamethasone course had a significantly lower incidence of RDS than those whose mothers were given partial courses.
METHODS: This was a retrospective chart review of 1800 women with preterm delivery. Data were collected on newborns whose mothers administered 1 full course of dexamethasone (916/1800; 50.9%), a partial course (716/1800; 39.8%) and more than 1 course (168/1800; 9.3%). Demographic data and adverse maternal and neonatal outcomes were recorded.
RESULTS: Preterm singleton newborns whose mothers received several steroid hormone courses were significantly more likely to have adverse outcomes than newborns of mothers given 1 course. The negative outcomes were the need for positive pressure ventilation ([aOR] 1.831; 95% CI, (1.185,2.829); P = 0.019), ventilator support ([aOR] 1.843; 95% CI, (1.187,2.861); P = 0.011), and phototherapy ([aOR] 1.997; 95% CI, (1.378,2.895); P < 0.001), transient tachypnoea of the newborn ([aOR] 1.801; 95% CI, (1.261,2.571); P = 0.002), intraventricular haemorrhage ([aOR] 2.215; 95% CI, (1.159, 4.233); P = 0.027), sepsis ([aOR] 1.737; 95% CI, (1.086, 2.777); P = 0.007), and admission to neonatal intensive care ([aOR] 1.822; 95% CI, (1.275,2.604); P = 0.001). In the group of very preterm infants, newborns of mothers administered an incomplete course had developed respiratory distress syndrome (RDS) ([aOR] 3.177; 95% CI, (1.485, 6.795); P = 0.006) and used ventilatory support ([aOR] 3.565; 95% CI, (1.912, 6.650); P < 0.001) more than those of mothers receiving a single course.
CONCLUSIONS: Preterm singleton newborns whose mothers were given multiple courses of dexamethasone had an increased incidence of RDS and other adverse outcomes than those of mothers receiving a full course. However, very preterm newborns whose mothers were administered 1 full dexamethasone course had a significantly lower incidence of RDS than those whose mothers were given partial courses.
摘要：
目的：比较不完全疗程和超过1疗程的地塞米松的效果，相对于单个完整课程的控制，胎儿呼吸问题和早产的其他不良后果。
方法：这是1800名早产妇女的回顾性图表回顾。收集了母亲服用1个疗程地塞米松的新生儿的数据（916/1800;50.9％），部分课程(716/1800;39.8%)和1个以上课程(168/1800;9.3%)。记录人口统计学数据以及不良的母婴结局。
结果：母亲接受几个类固醇激素疗程的早产单胎新生儿比母亲接受1疗程的新生儿更有可能出现不良结局。阴性结果是需要正压通气（[aOR]1.831;95％CI，（1.185,2.829）;P=0.019），呼吸机支持([aOR]1.843；95%CI，(1.187,2.861)；P=0.011)，和光疗（[aOR]1.997；95%CI，（1.378,2.895）；P<0.001），新生儿短暂性呼吸急促([aOR]1.801;95%CI,(1.261,2.571);P=0.002),脑室内出血([aOR]2.215;95%CI,(1.159,4.233);P=0.027),脓毒症（[aOR]1.737；95%CI，（1.086，2.777）；P=0.007），和入院新生儿重症监护([aOR]1.822;95%CI,(1.275,2.604);P=0.001)。在非常早产儿组中，与接受单疗程治疗的母亲相比，接受不完全疗程治疗的母亲的新生儿出现呼吸窘迫综合征（RDS）（[aOR]3.177；95％CI，（1.485，6.795）；P=0.006）和使用通气支持（[aOR]3.565；95％CI，（1.912，6.650）；P<0.001）。
结论：母亲接受多疗程地塞米松治疗的早产单胎新生儿与接受全疗程治疗的母亲相比，RDS和其他不良结局的发生率增加。然而,母亲接受1个完整地塞米松疗程的极早产新生儿的RDS发生率明显低于母亲接受部分疗程的新生儿.
方法：这是1800名早产妇女的回顾性图表回顾。收集了母亲服用1个疗程地塞米松的新生儿的数据（916/1800;50.9％），部分课程(716/1800;39.8%)和1个以上课程(168/1800;9.3%)。记录人口统计学数据以及不良的母婴结局。
结果：母亲接受几个类固醇激素疗程的早产单胎新生儿比母亲接受1疗程的新生儿更有可能出现不良结局。阴性结果是需要正压通气（[aOR]1.831;95％CI，（1.185,2.829）;P=0.019），呼吸机支持([aOR]1.843；95%CI，(1.187,2.861)；P=0.011)，和光疗（[aOR]1.997；95%CI，（1.378,2.895）；P<0.001），新生儿短暂性呼吸急促([aOR]1.801;95%CI,(1.261,2.571);P=0.002),脑室内出血([aOR]2.215;95%CI,(1.159,4.233);P=0.027),脓毒症（[aOR]1.737；95%CI，（1.086，2.777）；P=0.007），和入院新生儿重症监护([aOR]1.822;95%CI,(1.275,2.604);P=0.001)。在非常早产儿组中，与接受单疗程治疗的母亲相比，接受不完全疗程治疗的母亲的新生儿出现呼吸窘迫综合征（RDS）（[aOR]3.177；95％CI，（1.485，6.795）；P=0.006）和使用通气支持（[aOR]3.565；95％CI，（1.912，6.650）；P<0.001）。
结论：母亲接受多疗程地塞米松治疗的早产单胎新生儿与接受全疗程治疗的母亲相比，RDS和其他不良结局的发生率增加。然而,母亲接受1个完整地塞米松疗程的极早产新生儿的RDS发生率明显低于母亲接受部分疗程的新生儿.
