Fetal placental inflammation is associated with poor neonatal growth of preterm infants: a case-control study

Fetal placental inflammation is associated with poor neonatal growth of preterm infants: a case-control study
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胎儿胎盘炎症与早产儿新生儿生长不良相关:病例对照研究

DOI:
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发表时间:
2013
影响因子:
1.8
通讯作者:
V. Zanardo
V. Zanardo
中科院分区:
医学4区
文献类型:
--
作者:
D. Trevisanuto;C. Peruzzetto;F. Cavallin;S. Vedovato;E. Cosmi;S. Visentin;S. Chiarelli;V. Zanardo

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摘要 目的:确定组织学绒毛膜羊膜炎(HCA)与早产儿新生儿期的出生后生长是否存在相关性。方法:这项病例对照研究是针对妊娠 32 周之前所有分娩的胎盘进行的更大规模前瞻性组织学研究的一部分。符合条件的病例涉及所有诊断为 HCA 的胎盘。对照受试者是那些没有 HCA 的受试者,根据胎龄(±1 周)与病例受试者进行 1:1 匹配。对所有婴儿在产后前四周内的胎盘炎症状态和连续体重增加进行了分析。根据胎盘炎症扩展,HCA被定义为母体HCA(MHCA)或胎儿HCA(FHCA)。结果:在 320 对母婴中,71 对 (22.1%) 出现 HCA(27 名 MHCA 和 44 名 FHCA)。第21天和第28天体重增加的减少与FHCA的存在相关(β系数分别为 ± SE = −4.40 ± 2.21,p = 0.05和-6.92 ± 2.96,p = 0.02),而MHCA和MHCA之间没有发现显着差异。无 HCA 组。在调整了可能的混杂因素(母亲种族、产次、怀孕期间吸烟、婴儿性别、IUGR 状态、SGA 状态、产前类固醇、总液体摄入量、迟发性败血症、BPD)后,FHCA 和 MHCA 未被确定为每周体重增加的危险因素。结论:我们发现胎儿胎盘炎症与新生儿生长不良之间存在关联,但我们无法确定体重增加受影响最大的特定周。胎盘检查结果可用于识别存在产后生长障碍风险的早产儿。
Abstract Objective: To determine whether there is an association between histological chorioamnionitis (HCA) and postnatal growth of preterm infants in the neonatal period. Method: This case–control study is part of a larger prospective histological study on placentas performed in all deliveries prior to 32 weeks of gestation. Eligible cases involved all placentas with a diagnosis of HCA. Control subjects were those without HCA, matched 1:1 with case subjects according to gestational age (±1 week). Placental inflammatory status and serial weight gain were analyzed for all infants during the first four postnatal weeks. Based on placental inflammation extension, HCA was defined as maternal HCA (MHCA) or fetal HCA (FHCA). Results: Of the 320 mother–infant pairs, 71 (22.1%) presented with HCA (27 MHCA and 44 FHCA). Decreases in weight gain at 21 and 28 days were associated with the presence of FHCA (β coefficient ± SE = −4.40 ± 2.21, p = 0.05 and −6.92 ± 2.96, p = 0.02, respectively), whereas no significant differences were found between MHCA and no-HCA groups. FHCA and MHCA were not identified as risk factors of weekly weight gain, after adjusting for possible confounders (maternal ethnicity, parity, smoking during pregnancy, infant gender, IUGR status, SGA status, antenatal steroids, total fluid intake, late-onset sepsis, BPD). Conclusions: We found an association between fetal placental inflammation and poor neonatal growth but we were not able to identify a specific week wherein weight gain could be mostly affected. Placental findings may be used to identify preterm infants at risk of postnatal growth failure.
DOI: 10.1016/j.clp.2010.02.003
发表时间: 2010-06
影响因子: 2.1
作者:
Tita AT;Andrews WW
通讯作者: Andrews WW
DOI: --
发表时间: --
期刊: --
影响因子: --
作者:
T. McElrath;E. Allred;K. Boggess;K. Kuban;T. Michael O 'shea
通讯作者: T. McElrath;E. Allred;K. Boggess;K. Kuban;T. Michael O 'shea