Labor dystocia and risk of histological chorioamnionitis and funisitis: a study from a single tertiary referral center.
Labor dystocia and risk of histological chorioamnionitis and funisitis: a study from a single tertiary referral center.
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DOI：
10.1186/s12884-021-03719-3
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发表时间：
2021-03-30
影响因子：
3.1
通讯作者：
Fujimori K
中科院分区：
文献类型：
--
作者：
Kyozuka H;Murata T;Fukuda T;Suzuki E;Yazawa R;Yasuda S;Kanno A;Yamaguchi A;Hashimoto Y;Fujimori K
宫内炎症影响新生儿的短期和长期预后。组织学绒毛膜羊膜炎和绒毛膜炎分别是胎膜和脐带的急性炎症反应。虽然难产包括宫内炎症的潜在风险，但难产的组织学羊膜炎和绒毛膜炎的风险尚未得到评估。本研究旨在探讨难产与组织学绒毛膜羊膜炎和尿道炎风险之间的关系。在这项回顾性队列研究中，纳入了2015年至2020年期间在日本福岛医科大学医院接受胎盘和脐带组织病理学检查的病例。从数据中，回顾了难产和自然早产患者的病理表现。根据白细胞的位置，将胎盘（组织学绒毛膜羊膜炎）和脐带（绒毛膜炎）的炎症分为0-3级。采用多元logistic回归分析评价组织学羊膜炎、组织学羊膜炎≥2期、绒毛炎和绒毛炎≥2期的风险。在符合研究标准的317名妇女中，分别有83名难产和144名自然早产，另外90名妇女作为对照。产程难产是组织学羊膜炎（校正优势比为6.3,95%可信区间为1.9 ~ 20.5）、组织学羊膜炎分期≥2期（校正优势比为6.0,95%可信区间为1.7 ~ 21.8）、羊膜炎（校正优势比为15.4,95%可信区间为2.3 ~ 101.3）、羊膜炎分期≥2期（校正优势比为18.5,95%可信区间为2.5 ~ 134.0）的危险因素。自发性早产也是组织学羊膜炎（校正优势比为3.7,95%可信区间为1.7-7.8）、组织学羊膜炎分期≥2期（校正优势比为3.0,95%可信区间为1.2-7.9）和膀胱炎（校正优势比为6.6,95%可信区间为1.4-30.6）的危险因素。然而，自然早产的校正优势比小于难产。难产是严重的组织学绒毛膜羊膜炎和尿道炎的危险因素。组织学羊膜炎和绒毛膜炎对新生儿长期预后的影响有待进一步研究。
Intrauterine inflammation affects short- and long-term neonatal outcomes. Histological chorioamnionitis and funisitis are acute inflammatory responses in the fetal membranes and umbilical cord, respectively. Although labor dystocia includes a potential risk of intrauterine inflammation, the risk of histological chorioamnionitis and funisitis of labor dystocia has not been evaluated yet. This study aimed to examine the association between labor dystocia and risk of histological chorioamnionitis and funisitis. In this retrospective cohort study, the cases who underwent histopathological examinations of the placenta and umbilical cord at Fukushima Medical University Hospital, Japan, between 2015 and 2020, were included. From the dataset, the pathological findings of the patients with labor dystocia and spontaneous preterm birth were reviewed. Based on the location of leukocytes, the inflammation in the placenta (histological chorioamnionitis) and umbilical cord (funisitis) was staged as 0–3. Multiple logistic regression analysis was performed to evaluate the risk of histological chorioamnionitis, histological chorioamnionitis stage ≥2, funisitis, and funisitis stage ≥2. Of 317 women who met the study criteria, 83 and 144 women had labor dystocia and spontaneous preterm birth, respectively, and 90 women were included as controls. Labor dystocia was a risk factor for histological chorioamnionitis (adjusted odds ratio, 6.3; 95% confidential interval, 1.9–20.5), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 6.0; 95% confidence interval, 1.7–21.8), funisitis (adjusted odds ratio, 15.4; 95% confidence interval, 2.3–101.3), and funisitis stage ≥2 (adjusted odds ratio, 18.5; 95% confidence interval, 2.5–134.0). Spontaneous preterm birth was also a risk factor for histological chorioamnionitis (adjusted odds ratio, 3.7; 95% confidence interval, 1.7–7.8), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 3.0; 95% confidence interval, 1.2–7.9), and funisitis (adjusted odds ratio, 6.6; 95% confidence interval, 1.4–30.6). However, the adjusted odds ratio was smaller in spontaneous preterm births than in labor dystocia. Labor dystocia is a risk factor for severe histological chorioamnionitis and funisitis. Further studies are required to evaluate the effects of histological chorioamnionitis and funisitis on long-term neonatal outcomes.
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影响因子：
4.3
作者：
Kjaergaard, Hanne;Olsen, Jorn;Dykes, Anna-Karin
通讯作者：
Dykes, Anna-Karin
DOI：
10.1016/j.ejogrb.2018.06.015
发表时间：
2018-09-01
影响因子：
2.6
作者：
Kyozuka, Hyo;Yasuda, Syun;Fujimori, Keiya
通讯作者：
Fujimori, Keiya
DOI：
10.1016/s1084-2756(02)00188-4
发表时间：
2003-02-01
期刊：
Seminars in neonatology : SN
影响因子：
--
作者：
Jobe, Alan H
通讯作者：
Jobe, Alan H
急性绒毛膜炎和炎症炎：定义，病理特征和临床意义。
影响因子：
9.8
作者：
Kim CJ;Romero R;Chaemsaithong P;Chaiyasit N;Yoon BH;Kim YM
通讯作者：
Kim YM
影响因子：
4.3
作者：
Selin, Lotta;Wallin, Gunnar;Berg, Marie
通讯作者：
Berg, Marie