关键词: 产前, 地塞米松, 早产儿, 脑损伤, 神经行为

Abstract: Objective To investigate effect of prenatal use of dexamethasone on short-term and long-term prognosis of premature infants,so as to provide scientific reference for improving prognosis of preterm infants. Methods A total of 289 premature infants in Yancheng Maternal and Child Health Care Hospital from January to December in 2011 were analyzed retrospectively.All participants were divided into intervention group (n=128) and control group (n=161) according to whether dexamethasone was suitable for prenatal treatment.According to different gestational age (GA),the participants were further divided into three subgroups:GA＜30 weeks,30-33⁺⁶ weeks and ＞34 weeks.General data and follow-up data of the different groups were compared. Results In children with GA under 30 weeks,the incidence of PWMD+DWMD,PVL,PIVH-IVH and social interaction score at the age of 3 and 6 years old in intervention group were significantly lower than those in control group(χ²=4.493,4.493,4.305,t=2.454,5.832,P＜0.05).And the scores of gross motor behavior and fine motor behavior at the age of 1,2,3,6 years old in intervention group were significantly higher than those in control group(t=3.599,4.231,4.626,8.552,9.171,6.742,P＜0.05).In children with GA 30-33⁺⁶ weeks,the incidence of PVL and PIVH-IVH,and social interaction score at the age of 3 and 6 years old in intervention group were significantly lower than those in control group(χ²=4.182,3.852, t=3.431,2.867,P＜0.05).And the scores of gross motor behavior and fine motor behavior at the age of 1,2,3,6 years old in intervention group were significantly higher than those in control group(t=2.346,2.975,6.446,5.392,2.541,4.683,1.871,6.043,P＜0.05).In children with gestational age over 34 weeks,the scores of gross motor behavior and fine motor behavior at the age of 2,3,6 years old in intervention group were significantly higher than those in control group(t=2.236,3.184,6.130,2.569,5.506,5.131,P＜0.05),while the scores of social interaction at the age of 3 and 6 years old were significantly lowerer than those in control group (t=2.473,2.315,P＜0.05). Conclusion Prenatal application of dexamethasone is of certain protective effect on brain injury of premature infants with small gestational age,and has positive effect on long-term motor and behavior development of premature infants.However,its negative effect on long-term personal social behavior of premature infants is supposed to be considered.

Key words: prenatal, dexamethasone, premature infants, brain damage, neurobehavior