The presence of funisitis is associated with a decreased risk for the development of neonatal respiratory distress syndrome
The presence of funisitis is associated with a decreased risk for the development of neonatal respiratory distress syndrome
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DOI：
10.1016/j.placenta.2010.11.006
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发表时间：
2011-03-01
期刊：
影响因子：
3.8
通讯作者：
Yoon, B. H.
中科院分区：
文献类型：
--
作者：
Lee, J.;Oh, K. J.;Yoon, B. H.
目的：宫内炎症暴露对胎儿肺成熟和呼吸结局有影响。胃底炎被认为是胎儿炎症反应的组织学标志。这项研究的目的是确定新生儿呼吸窘迫综合征(RDS)的发生率是否因妊娠前有无瘘管炎而不同。研究设计：对连续301例单胎早产儿(孕24-32周)进行胃底炎与新生儿呼吸窘迫综合征(RDS)发生的关系的研究。排除无胎盘组织学检查和有重大先天畸形的病例。胎盘组织学检查发现胎盘有中性粒细胞渗入脐管壁或华顿凝胶者诊断为胃底炎。结果：25%的病例诊断为胃底炎，46%的病例诊断为RDS。有胃底炎的婴儿RDS的发生率低于无胃底炎的婴儿(28.4%对51.1%)。P=0.001)。Logistic回归分析表明，在调整混杂变量后，胃底炎的出现与RDS风险降低相关(优势比=0.44)。95%可信区间为0.22~0.90)。RDS发生率的下降趋势与组织学绒毛膜羊膜炎和胃底炎的存在有关(p<；0.001)。结论：胃底炎的存在与早孕新生儿RDS的发生风险降低有关。此外，这一观察结果表明，胎儿胎盘炎症的参与可能有利于胎儿肺的成熟。(C)2010爱思唯尔有限公司。保留所有权利。
Objectives: Fetal lung maturation and respiratory outcomes are influenced by the exposure to intrauterine inflammation. Funisitis is considered as the histologic hallmark of fetal inflammatory response. This study was performed to determine if there is a difference in the rate of neonatal respiratory distress syndrome (RDS) according to the presence or absence of funisitis in preterrn gestations.Study design: The relationship between the presence of funisitis and the development of neonatal RDS was examined in 301 consecutive singleton preterm births (24-32 weeks' gestation). Cases without placental histological examination and those with major congenital anomalies were excluded. Funisitis was diagnosed in the presence of neutrophil infiltration into the umbilical vessel walls or Wharton's jelly on the placental histological examination.Results: Funisitis was diagnosed in 25% and RDS was diagnosed in 46% of cases. The rate of RDS in babies with funisitis was lower than in those without funisitis (28.4% vs. 51.1%. p = 0.001). Logistic regression analysis demonstrated that the presence of funisitis was associated with a decreased risk for RDS after adjusting for confounding variables (Odds ratio = 0.44. 95% CI 0.22-0.90). The downward trend of the frequency of RDS was related to the presence of histologic chorioamnionitis and funisitis (p < 0.001).Conclusions: The presence of funisitis is associated with a decreased risk for the development of neonatal RDS in preterm gestations. Furthermore, this observation suggests that the fetal involvement of placental inflammation may be beneficial to the maturation of the fetal lung. (C) 2010 Elsevier Ltd. All rights reserved.