Outcome of neonates less than 30 weeks gestation with histologic chorioamnionitis
Outcome of neonates less than 30 weeks gestation with histologic chorioamnionitis
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DOI：
10.1055/s-2005-865020
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发表时间：
2005-04-01
影响因子：
2
通讯作者：
Usher, R
中科院分区：
文献类型：
--
作者：
Dempsey, E;Chen, MF;Usher, R
本研究的目的是确定妊娠小于 30 周的新生儿在患有明确的胎盘组织学绒毛膜羊膜炎时的短期结局。对 1989 年 1 月至 1999 年 1 月期间在我们机构分娩的所有新生儿的记录进行了回顾性分析。这些信息是从我们的围产期数据库和病理学数据库中检索的。根据是否存在组织学绒毛羊膜炎对人群进行分层。使用学生 t 检验和曼-惠特尼方法进行统计分析。使用逻辑回归来控制潜在的混杂变量。在此期间，共有 392 名妊娠不满 30 周的新生儿出生。 342 名患者 (87.4%) 可获得完整的胎盘组织学资料。 140 例（40.9%）病例中发现组织学绒毛羊膜炎。患有组织学绒毛羊膜炎的患者分娩较早（26.3 周与 27.5 周），出生体重较低（920.1 与 1029.8 克），并且 5 分钟 Apgarscore 较低。新生儿败血症和肺炎与潜在的组织学绒毛膜羊膜炎密切相关。当存在组织学绒毛膜羊膜炎时，呼吸窘迫综合征（RDS）的发生率显着降低。严重的组织学绒毛膜羊膜炎会增加早产的风险，并且与新生儿败血症密切相关。 RDS 的发生率和新生儿死亡率显着降低。
The purpose of this study was to determine the short-term outcome of newborns less than 30 weeks gestation when there is definite placental histologic chorioamnionitis. A retrospective analysis was performed of records of all neonates delivered at our institution from January 1989 through January 1999. This information was retrieved from our perinatal database and pathology database. The population was stratified according to the presence or absence of histologic chorloamnionitis. Statistical analysis was performed using student t-test and Mann-Whitney method. Logistic regression was used to control for potential confounding variables. There were 392 neonates less than 30 weeks gestation delivered during this time period. Complete placental histology was available for 342 patients (87.4%). Histologic chorloamnionitis was identified in 140 (40.9%) cases. Those with histologic chorloamnionitis delivered sooner (26.3 versus 27.5 weeks), were of lower birth weight (920.1 versus 1029.8 g), and had lower 5-minute Apgarscores. Neonatal septicaemia and pneumonia were strongly associated with underlying histologic chorioamnionitis. There was a significant reduction in the incidence of respiratory distress syndrome (RDS) when histologic chorioamnionitis was present. Severe histologic chorioamnionitis increases the risk of premature delivery and is strongly associated with neonatal sepsis. There is a significant reduction in the incidence of RDS and neonatal mortality.