The Effect Of Antenatal Corticosteroids In HCA Mothers On Early Respiration And Infection In Preterm Infants With Gestationalage ＜34 Weeks

Objective: To investigate the effect of antenatal corticosteroids(ACS)on early respiratory status and infection rate in preterm infants(gestational age ＜34 weeks)delivered to mothers with histological chorioamnionitis(HCA).Methods: Collection the clinical data of the preterm infants and their mothers who completed placental pathological examination indicated HCA from November 2017 to June 2020 was born in the obstetrics department of Qingdao Women’s and Children’s Hospital and were admitted to the neonatal intensive care unit of the hospital whose gestational age was less than 34 weeks.A total of 265 cases were included after excluding premature infants with born in other hospitals,death or incomplete data,genetic metabolic system diseases or chromosome abnormalities,severe congenital malformations.According to the mother’s use of antenatal corticosteroids(both for dexamethasone),the preterm infants were divided into group not using ACS(control group),group using 1-2 times(group I),and group using 3-4 times(group II).Collect and analyze prenatal and postnatal data to understand the differences in general data,clinical data and treatment among the three groups of cases.And the relationship between the general data,clinical data and treatment of premature infants with RDS and BPD and the use of ACS by mothers with HCA was compared.Analyse and compare the effects of antenatal corticosteroids in mothers with histological chorioamnionitis on early respiratory and infection of preterm infants whose gestational age was less than 34 weeks.Results:1.A total of 265 premature infants who met the inclusion criteria were included in the study.There were 46 cases(17.36%)in the control group,60 cases(22.64%)in group I,and 159 cases(60%)in group II.The utilization rate of glucocorticoids was 82.64%.2.The Apgar score at 1 minute and 5 minutes in group II was higher than that in the control group,the Apgar score at 5 minutes in group II was higher than that in group I,and the lactate values of blood gas measurement in groups I and II were both lower than those in the control group,the difference was statistically significant.(P＜0.05)3.The proportion of invasive respiratory support in group I was lower than that in the control group,the total respiratory support time,non-invasive ventilation time and respiratory distress score in group II were lower than those in the control group,and the oxygenation index in group I was higher than that in the control group,the difference was statistically significant.(P＜0.05)4.The incidence of respiratory failure in the control group was higher than that in the group I and group II;the incidence of RDS and BPD in the control group was higher than that in the group II,the difference was statistically significant.(P＜0.05)5.There was no significant difference in the prenatal infection indicators of mothers and postnatal infection indicators of premature infants among the groups.6.Application of ACS can reduce the incidence of RDS and BPD in premature infants,and protect the respiratory function of premature infants.7.In preterm infants with RDS、BPD born to mothers with HCA,the application of ACS can reduce the application rate of invasive respiratory support in premature infants and the respiratory distress score,protect the respiratory function of premature infants.Conclusion:1.The use of antenatal corticosteroids by mothers with HCA has a protective effect on early respiratory function of premature infants with a gestational age of less than 34 weeks,and will reduce the incidence of RDS and BPD complications in premature infants.2.Antenatal corticosteroids for full or near full course of treatment can better protect the respiratory function of premature infants in HCA mothers.3.Antenatal corticosteroids use in mothers with HCA has not been shown to increase the risk of infection in preterm infants.