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Neonatal Morbidities Associated with Histologic Chorioamnionitis Defined Based on the Site and Extent of Inflammation in Very Low Birth Weight Infants

机译:根据出生体重极低的婴儿的部位和炎症程度定义的与组织学绒毛膜羊膜炎相关的新生儿发病率

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Conflicting results on the influences of histologic chorioamnionitis (HC) on neonatal morbidities might be partly originated from using different definition of HC. The aim of this study was to determine the relationship between HC and neonatal morbidities using definition of HC that reflects the site and extent of inflammation. This was a retrospective cohort study of 261 very low birth weight (VLBW) infants admitted at a tertiary academic center. Based on the site of inflammation, HC was categorized: any HC; amnionitis; funisitis; amnionitis+funisitis. The extent of inflammation in each site was reflected by sub-defining high grade (HG). The incidences of morbidities in infants with and without HC were compared. The bronchopulmonary dysplasia (BPD) rate was significantly higher in infants with amnionitis and the severe retinopathy of prematurity (ROP) rate was significantly higher in infants with any HC and funisitis. After adjustment for both gestational age and birth weight, the respiratory distress syndrome (RDS) rate was significantly lower in infants with all categories of HC except for HG amnionitis and HG funisitis, which are not associated with lower RDS rate. HG amnionitis was significantly associated with increased BPD rate but the association of HC with severe ROP disappeared. In conclusion, HC is significantly associated with decreased RDS and HG amnionitis with increased BPD while lacking association with other neonatal morbidities in VLBW infants. The association with HC and neonatal morbidities differs by the site and extent of chorioamnionitis. Graphical Abstract
机译:关于组织学绒毛膜羊膜炎(HC)对新生儿发病率影响的结果相互矛盾,可能部分源于使用不同的HC定义。这项研究的目的是使用反映炎症部位和程度的HC定义来确定HC与新生儿发病率之间的关系。这是一项对三级学术中心录取的261例极低出生体重(VLBW)婴儿的回顾性队列研究。根据发炎的部位,可将HC分为以下几类:羊膜炎真菌炎羊膜炎+尿囊炎。每个部位的炎症程度通过亚定义高等级(HG)来反映。比较了有和没有HC的婴儿的发病率。患有羊膜炎的婴儿的支气管肺发育不良(BPD)率明显更高,患有任何HC和真菌炎的婴儿的严重早产儿视网膜病变(ROP)率显着更高。调整胎龄和出生体重后,除HG羊膜炎和HG真菌炎外,所有类别HC的婴儿的呼吸窘迫综合征(RDS)率均显着降低,而这与RDS降低无关。 HG羊膜炎与BPD率升高显着相关,但HC与严重ROP的相关性消失。总之,HC与RVDS婴儿中RDS降低和HG羊膜炎伴BPD升高显着相关,而与其他新生儿发病率缺乏相关性。绒毛膜羊膜炎的部位和程度与HC和新生儿发病率的关系不同。图形概要

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