Maternal or neonatal infection: association with neonatal encephalopathy outcomes.
Maternal or neonatal infection: association with neonatal encephalopathy outcomes.
复制标题
DOI：
10.1038/pr.2014.47
复制
发表时间：
2014-07
影响因子：
3.6
通讯作者：
Glass, Hannah C.
中科院分区：
文献类型：
--
作者：
Jenster, Meike;Bonifacio, Sonia L.;Ruel, Theodore;Rogers, Elizabeth E.;Tam, Emily W.;Partridge, John Colin;Barkovich, Anthony James;Ferriero, Donna M.;Glass, Hannah C.
围产期感染可能会加重早产儿的脑损伤。本研究的目的是检查母亲和/或新生儿感染是否与足月新生儿脑病的不良结局相关。对258例脑病足月新生儿进行队列研究，检查其临床记录是否有母体感染（绒毛膜炎）和婴儿感染（败血症）的体征。使用多变量回归分析评估新生儿MRI上的感染、损伤模式和严重程度以及30个月时的神经发育（神经运动检查或Bayley婴儿发育量表II MDI <70或Bayley III认知评分<85）之间的相关性。与无绒毛膜炎的儿童相比，绒毛膜炎与中重度脑损伤风险降低（调整OR 0.3; 95%CI 0.1-0.7，P=0.004）和不良认知结局相关。有新生儿败血症体征的儿童比无新生儿败血症体征的儿童更可能表现出分水岭优势损伤（P=0.007）。在新生儿脑病中，绒毛膜炎与脑损伤和不良结局的风险较低相关，而新生儿败血症体征的风险较高。脑病的病因学和感染的时间及其相关的炎症反应可能会影响感染是否加重或减轻足月新生儿的损伤。
Perinatal infection may potentiate brain injury among children born preterm. The objective of this study was to examine whether maternal and/or neonatal infection are associated with adverse outcomes among term neonates with encephalopathy. Cohort study of 258 term newborns with encephalopathy whose clinical records were examined for signs of maternal infection (chorioamnionitis) and infant infection (sepsis). Multivariate regression was used to assess associations between infection, pattern and severity of injury on neonatal MRI, as well as neurodevelopment at 30 months (neuromotor exam, or Bayley Scales of Infant Development II MDI <70 or Bayley III cognitive score <85). Chorioamnionitis was associated with lower risk of moderate-severe brain injury (adjusted OR 0.3; 95% CI 0.1–0.7, P=0.004), and adverse cognitive outcome in children when compared to no chorioamnionitis. Children with signs of neonatal sepsis were more likely to exhibit watershed predominant injury than those without (P=0.007). Among neonates with encephalopathy, chorioamnionitis was associated with a lower risk of brain injury and adverse outcomes, whereas signs of neonatal sepsis carried an elevated risk. The etiology of encephalopathy and timing of infection and its associated inflammatory response may influence whether infection potentiates or mitigates injury in term newborns.
登录
查看更多内容
影响因子：
3.6
作者：
Bartha, AI;Foster-Barber, A;Ferriero, DM
通讯作者：
Ferriero, DM
影响因子：
3.6
作者：
Leviton, A;Paneth, N;Pagano, M
通讯作者：
Pagano, M
DOI：
10.1001/archpediatrics.2010.20
发表时间：
2010-04-01
影响因子：
--
作者：
Anderson, Peter J.;De Luca, Cinzia R.;Doyle, Lex W.
通讯作者：
Doyle, Lex W.
影响因子：
5.1
作者：
Miller, SP;Ramaswamy, V;Ferriero, DM
通讯作者：
Ferriero, DM
影响因子：
9.3
作者：
Brochu ME;Girard S;Lavoie K;Sébire G
通讯作者：
Sébire G