Neonatal outcomes in the setting of preterm premature rupture of membranes complicated by chorioamnionitis
Neonatal outcomes in the setting of preterm premature rupture of membranes complicated by chorioamnionitis
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DOI：
10.3109/14767050902922581
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发表时间：
2009-09-01
影响因子：
1.8
通讯作者：
Caughey, Aaron B.
中科院分区：
文献类型：
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作者：
Aziz, Natali;Cheng, Yvonne W.;Caughey, Aaron B.
目标。目的：探讨早产儿胎膜早破（PPROM）情况下绒毛膜羊膜炎妇女所生新生儿的预后。一项回顾性队列研究在一个学术医疗中心进行了24至34周妊娠诊断为PPROM的分娩。将诊断为临床绒毛膜羊膜炎分娩的患者与未诊断为临床绒毛膜羊膜炎分娩的患者进行比较。评估新生儿结局，包括Apgar评分、颅内出血（ICH）、败血症、肺炎、呼吸窘迫综合征（RDS）和坏死性小肠结肠炎（NEC）。二分类结果比较采用卡方检验。采用多变量回归分析控制潜在的混杂变量。在诊断为PPROM的1153例患者中，29.0%在分娩前诊断为绒毛膜羊膜炎。经PPROM诊断为绒毛膜羊膜炎的母亲所生的新生儿低5分钟Apgar评分、RDS、NEC、ICH和肺炎的发生率（34.8%）高于无绒毛膜羊膜炎母亲所生的新生儿（22.9%）（p < 0.001）。与未发生羊膜膜炎的PPROM患者相比，PPROM患者发生羊膜膜膜炎的新生儿不良结局风险更高。
Objective. To examine the outcomes of neonates born to women with chorioamnionitis in the setting of preterm premature rupture of membranes (PPROM).Methods. A retrospective cohort study was conducted of deliveries with diagnosis of PPROM between 24 and 34 weeks of gestation at an academic medical center. Patients who delivered with the diagnosis of clinical chorioamnionitis were compared with patients who delivered without this diagnosis. Neonatal outcomes including Apgar scores, intracranial hemorrhage (ICH), sepsis, pneumonia, respiratory distress syndrome (RDS), and necrotizing enterocolitis (NEC) were assessed. Dichotomous outcomes were compared using chi-square test. Multivariable regression analyses were performed to control for potential confounding variables.Results. Of the 1153 patients diagnosed with PPROM, 29.0% were diagnosed with chorioamnionitis prior to delivery. Neonates born to mothers with a diagnosis of chorioamnionitis in the setting of PPROM had higher incidences (34.8%) of low 5-min Apgar scores, RDS, NEC, ICH, and pneumonia compared with 22.9% in neonates born to mothers without chorioamnionitis (p < 0.001).Conclusions. Patients who develop chorioamnionitis in the setting of PPROM are at higher risk for adverse neonatal outcomes compared with patients without chorioamnionitis in the setting of PPROM.