Chorioamnionitis, mechanical ventilation, and postnatal sepsis as modulators of chronic lung disease in preterm infants
Chorioamnionitis, mechanical ventilation, and postnatal sepsis as modulators of chronic lung disease in preterm infants
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DOI：
10.1067/mpd.2002.121381
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发表时间：
2002-02-01
影响因子：
5.1
通讯作者：
Martin, C
中科院分区：
文献类型：
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作者：
Van Marter, LJ;Dammann, O;Martin, C
目的：这项慢性肺部疾病(CLD)病例对照研究评估了绒毛膜羊膜炎促进CLD并与其他危险因素相互作用的假说，包括机械通气和出生后感染。研究设计：我们确定了193名符合CLD病例标准的新生儿，他们的出生体重为1500g。这些婴儿与对照组的胎龄和出生医院1：1匹配。结果：单因素分析显示，CLD的风险降低与组织学绒毛膜羊膜炎有关，而与机械通气和7天及培养记录的败血症有关。在多变量分析中，当婴儿同时暴露于绒毛膜羊膜炎和机械通气7天(优势比3.2；95%可信区间0.9-11)或产后感染(优势比2.9；95%可信区间1.1-7.4)时，他们发生CLD的风险最大。结论：我们得出结论：延长机械通气或出生后感染增加了存活早产儿CLD的风险，这两个因素与产前感染相互作用，进一步增加了CLD的风险。
Objective: This case-control study of chronic lung disease (CLD) evaluated the hypothesis that chorioamnionitis promotes CLD and interacts with other risk factors for CLD, including mechanical ventilation and postnatal infection.Study design: We identified a population of 193 infants who met our case criteria for CLD whose birth weights were: 1500 g. These infants were matched 1: 1 with control infants for gestational age and hospital of birth.Results: Univariable analyses revealed decreased CLD risk associated with histologic chorioamnionitis and increased risk associated with mechanical ventilation >7 days and culture-documented sepsis. In multivariable analyses, infants were at greatest risk for CLD when they had exposure to both chorioamnionitis and either mechanical ventilation >7 days (odds ratio, 3.2; 95% confidence interval, 0.9-11) or postnatal infection (odds ratio, 2.9; 95% confidence interval, 1.1-7.4).Conclusions: We conclude that prolonged mechanical ventilation or postnatal infection increases the risk of CLD among surviving preterm infants and that these 2 factors interact with antenatal infection to further increase the risk of CLD.