Williams M C, O'Brien W F, Nelson R N, Spellacy W N
Department of Obstetrics and Gynecology, The University of South Florida College of Medicine, Tampa, FL 33606, USA.
Am J Obstet Gynecol. 2000 Nov;183(5):1094-9. doi: 10.1067/mob.2000.108866.
Our aim was to evaluate associations between chorioamnionitis and fetal growth restriction in infants enrolled in the Collaborative Perinatal Project.
A total of 2579 nonanomalous, singleton infants delivered at 28 to 44 weeks' gestation with chorioamnionitis were matched 1:3 for ethnicity, gestational age, parity, and maternal cigarette use (all of which were correlated with both chorioamnionitis and markers of fetal growth restriction) with 7732 control infants. Moderate or marked leukocytic infiltrates of the placenta defined chorioamnionitis. Birth weight, length, head circumference, weight/length ratio, ponderal index, and birth weight/head circumference ratio in the lowest 5th percentile were markers of fetal growth restriction. Placental weight and the birth weight/placental weight ratio were also evaluated.
Compared with data on matched control infants, histologic chorioamnionitis was associated with all markers of fetal growth restriction and with low birth weight/placental weight ratios (odds ratios, 1.3-1.7). The strongest associations were found at 28 to 32 weeks' gestation (odds ratios, 2.2-11). Attributable risks for several markers of fetal growth restriction exceeded 50% in infants born at <33 weeks' gestation.
Histologic chorioamnionitis is associated with multiple markers of fetal growth restriction, with stronger associations noted in prematurity.
我们的目的是评估参与围产期协作项目的婴儿中绒毛膜羊膜炎与胎儿生长受限之间的关联。
共有2579例在妊娠28至44周时分娩的非畸形单胎婴儿患有绒毛膜羊膜炎，根据种族、孕周、产次和母亲吸烟情况（所有这些因素均与绒毛膜羊膜炎和胎儿生长受限指标相关）按1:3与7732例对照婴儿进行匹配。胎盘有中度或显著的白细胞浸润定义为绒毛膜羊膜炎。出生体重、身长、头围、体重/身长比、 ponderal指数以及处于第5百分位数以下的出生体重/头围比是胎儿生长受限的指标。还评估了胎盘重量和出生体重/胎盘重量比。
与匹配的对照婴儿数据相比，组织学绒毛膜羊膜炎与胎儿生长受限的所有指标以及低出生体重/胎盘重量比相关（优势比为1.3 - 1.7）。在妊娠28至32周时发现的关联最强（优势比为2.2 - 11）。在孕周小于33周出生的婴儿中，几种胎儿生长受限指标的归因风险超过50%。
组织学绒毛膜羊膜炎与胎儿生长受限的多种指标相关，在早产中关联更强。
