The Clinical Characteristics Of Premature Newborns Treated By Dexameth And Diagnosded As NRDS

Objective:To summarize the clinical characteristics of the group of preterm infants who were treated by Dexameth antepartum and were diagnosed as neonatal respiratory distress syndrome postpartum.And,to research the factors that may influence the preventive treatmengt of Dex.Method:Retrospective analysis was done in the groups of 279 preterm infants who were diagnosed as NRDS in children's hospital of Chongqing medical university from Jan 2003 to Sep 2007.The group were separated into two subgroup by the standard of whether they have used Dex antepartum(treatment group and untreatment group) and each subgroup was separated into < 34 weeks or≥34 weeks subgroup by gestational age.We compared the clinical characteristics which include Apgar score,chest X-ray grading and the days of using ventilator between the treatment group and the untreatment group. Reasult:1. Compare the clinical characteristics between the treatment group and the untreatment group,the proportion of multiple pregnancy in treatment group and unteatment group was 40.0% and 19.6% separately,the incidence of cholestasis of pregnancy was 9.3% and 1.5% separately,the incidence of diabetes mellitus was 5.3% and 2.0% separately and the incidence of hypertension syndrome of pregnancy was 13.3% and 5.9% separately,these differences between the two groups are all statistically significant(P<0.05).2. In the group of NRDS patitent whose gestational age were less than 34 weeks,the mean of the Apgar scores in treatment group patients was 7 .78±2.17 in 1 minute and 8.59±1.69 in 5 minute compared to that of the untreatment group patient was 6.41±2.16 in 1 minute and 7.15±2.17 in 5 minute , these differences between two groups are also statistically significant(P<0.05).3. In the group of NRDS patitent whose gestational age were less than 34 weeks, Most of the chest X-ray grading in treatment group was sorted into gradeⅠandⅡ,the percentage was 87.7%,in contrast,the percentage of gradeⅢandⅣin untreatment group was 29.8%,this difference also has satistically significant(P<0.05).4. To compare the mean days of using ventilator in group of cured patients whose gestational age were less than 34 weeks,3.35±1.80 days in treatment group and 4.55±2.57 days in untreatment group are statistically different(P<0.05).5. In the treatment group,most of the dosage time was in the period of less than 24 hour before delivery or from 48 hours to 7 days before delivery.Because of the limitation of history taking,the record of the dosage and administration route of Dex was incomplete.According to recent data,most accepted dosage and administration route of Dex is 10 mg through intramuscular injection or intravenous injection,of which intramuscular injection is the leading administration route.Conclusion:1. The preventive treatment of Dex may be influenced by multiple factors such as maternal disease during pregnancy,multiple pregnancy,dosage time,and so on.Also,it,s supposed to be concerned with gene defect.2. Although Dex antepartum cannot completely avoid the occurence of NRDS,it still can release the severity of the NRDS.3. Indicator of Dex should be carefully mastered,at the same times,to consider the potential side effect,we should look for other drugs.