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首页> 外文期刊>Obstetric medicine >Antenatal steroids for fetal lung maturity: Time to target more frequent doses to fewer women?
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Antenatal steroids for fetal lung maturity: Time to target more frequent doses to fewer women?

机译：胎儿肺成熟的产甾类固醇：时间靶向更频繁的剂量减少女性？

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摘要

Antenatal corticosteroids for fetal lung maturation have become mainstay treatment in women thought to be at high-risk of premature birth. To ensure treatment efficacy before delivery, the current practice is to administer steroids early to a woman considered at risk; however, neonatal benefit is lost after the seven-day treatment-to-delivery window. Over half of women who deliver before 34 weeks’ gestation do not receive antenatal corticosteroids within this timeframe, but many still deliver prematurely; however, clinicians are reluctant to administer repeated courses of steroids due to concerns, among others, of impaired fetal growth. However, evidence is mounting regarding the optimal timing for steroids, including substantive benefits close to delivery, and the benefits of repeated courses if delivery has not occurred. Better targeted treatment is required to allow for maximum benefit; reducing unnecessary treatment in low-risk women, while targeting therapy in the high-risk cohort and offering repeat courses if the seven-day window is exceeded. Novel tools to aid prediction may help implement this strategy.
机译：胎儿肺成熟的产前皮质类固醇已成为妇女的主干治疗，以为高危到早产的高风险。为了确保在发货前进行治疗效果，目前的做法是向一名受风险考虑的女性提前施用类固醇;然而，在七天的治疗到交付窗口后，新生儿益处将失去。超过一半的女性在34周内妊娠之前没有收到该时间表内的产前皮质类固醇，但许多仍然仍在过早提供;然而，由于胎儿生长受损，临床医生因患有受损的担忧而不愿意施用重复的类固醇疗程。然而，证据正在安装关于类固醇的最佳时间，包括靠近交付的实质性益处，如果没有发生交付，则重复课程的益处。需要更好的有针对性的治疗来实现最大利益;减少低危妇女的不必要治疗，同时在高风险队列中靶向治疗，如果超过七天窗口，则提供重复课程。援助预测的新工具可能有助于实施这种策略。

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