Association of Placental Pathologic Findings with the Severity of Necrotizing Enterocolitis in Preterm infants - A Matched Case-Control Study
Association of Placental Pathologic Findings with the Severity of Necrotizing Enterocolitis in Preterm infants - A Matched Case-Control Study
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DOI：
10.1080/15513815.2022.2110340
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发表时间：
2022-08-05
影响因子：
1.1
通讯作者：
Mir, Imran N.
中科院分区：
文献类型：
--
作者：
Garg, Parvesh Mohan;Paschal, Jaslyn L.;Mir, Imran N.
目的探讨早产儿坏死性小肠结肠炎（NEC）严重程度与胎盘病理的关系。方法本研究采用单中心病例对照研究方法，选取2013年至2020年出生的NEC患儿107例，对照组130例为胎龄和出生体重相匹配的对照组。根据阿姆斯特丹胎盘工作组共识声明对胎盘进行评价。结果急性组织学绒毛膜炎伴胎儿反应在手术NEC的婴儿中比药物NEC的婴儿更常见（35.4%比15.3%; p = 0.02）。在回归模型中，患有多种胎盘病变（OR 2.16; 95% CI 1.01 - 4.73; p = 0.04）和母体血管灌注不良（OR 2.2; 95% CI 1.12 - 4.51; p = 0.02）的婴儿发生内科或外科NEC的几率高于对照组。结论胎盘炎性病变和血管性病变是新生儿发生内科或外科NEC的高危因素。
Objective To determine the association of placental pathology with the severity of necrotizing enterocolitis (NEC) in preterm infants. Methods This single-center matched case-control study included infants with NEC (n = 107) and gestational age and birth weight-matched controls (n = 130), born between 2013 and 2020. Placentas were evaluated according to the Amsterdam Placental Workshop Group Consensus Statement. Results Acute histologic chorioamnionitis with the fetal response was significantly more common in infants with surgical NEC vs. medical NEC (35.4% vs. 15.3%; p = 0.02). On regression model, infants with multiple placental pathologies (OR 2.16; 95% CI 1.01 - 4.73; p = 0.04) and maternal vascular malperfusion (OR 2.2; 95% CI 1.12 - 4.51; p = 0.02) had higher odds of either medical or surgical NEC than controls. Conclusion Infants with multiple placental lesions, including placental inflammatory and vascular lesions, were at higher risk of medical or surgical NEC in the postnatal period.