摘要目的:探讨使用不同疗程产前糖皮质激素（antenatal corticosteroids，ACS）干预的双胎早产儿短期临床结局。方法:采用回顾性队列研究，选取2017年1月至2021年12月昆明医科大学第一附属医院新生儿病房收治、接受ACS干预的双胎早产儿为研究对象。以ACS使用疗程不同分为单一疗程组、不足疗程组和重复疗程组，分析ACS不同疗程干预的双胎早产儿短期结局。应用SPSS 25.0统计软件进行数据分析。结果:共纳入286例，其中单一疗程组128例，不足疗程组89例，重复疗程组69例。与单一疗程组相比，不足疗程组（ OR=2.332，95% CI 1.028~5.293， P=0.043）和重复疗程组（ OR=3.872，95% CI 1.104~13.584， P=0.034）双胎早产儿发生新生儿呼吸窘迫综合征的风险增加，重复疗程组出生身长（ β=-0.016，95% CI -0.029~-0.002， P=0.024）降低。 结论:不足疗程和重复疗程使用ACS的双胎早产儿新生儿呼吸窘迫综合征发生风险增加。在获得进一步有效证据之前，应按照足疗程规范使用ACS。

abstractsObjective:To study the short-term clinical outcomes of different courses of antenatal corticosteroids (ACS) for preterm twins.Methods:From January 2017 to December 2021, preterm twins with gestational age (GA) 24-34 weeks admitted to the neonatal ward of our hospital and received ACS were retrospectively studied. The infants were assigned into single-course group, partial-course group and multiple-course group according to ACS courses. The short-term clinical outcomes were compared among the groups. SPSS software version 25.0 was used for statistical analysis.Results:A total of 286 infants were enrolled in this study, including 128 in single-course group, 89 in partial-course group and 69 in multiple-course group. Compared with single-course group, the risks of neonatal respiratory distress syndrome (RDS) in both partial-course group ( OR=2.332, 95% CI 1.028-5.293, P=0.043) and multiple-course group ( OR=3.872, 95% CI 1.104-13.584, P=0.034) were higher. The birth length in multiple-course group ( β=-0.016, 95% CI -0.029 - -0.002, P=0.024) was lower than single-course group. Conclusions:The risks of neonatal RDS in preterm twins are higher in partial-course and multiple-course of ACS. A full course of ACS should be used to prevent neonatal RDS until further evidence of effectiveness is available.