Shalak Lina, Johnson-Welch Sarah, Perlman Jeffrey M
Department of Pediatrics, University of Texas, Southwestern Medical Center, Dallas, Texas, USA.
Pediatr Neurol. 2005 Sep;33(3):162-5. doi: 10.1016/j.pediatrneurol.2005.04.005.
The aim of this study was to determine whether the presence or severity of histologic abnormalities of infection/inflammation such as chorioamnionitis, vasculitis, or funisitis confers an additional risk for neonatal encephalopathy in term infants delivered in the presence of severe fetal acidosis. The medical records as well as placental pathology of term infants (n = 51) born with a cord umbilical arterial pH <7.00 were reviewed. Abnormal outcome was predefined as Sarnat stage 2 or 3 neonatal encephalopathy in the first week of life or neonatal death as a consequence of severe brain injury. Consistent with prior data, the presence of severe fetal acidemia, a low 5-minute Apgar score, and need for cardiopulmonary resuscitation were significantly associated with neonatal encephalopathy. However, the presence of histologic chorioamnionitis had a poor predictive value and did not confer additional risk for the subsequent development of neonatal encephalopathy.
本研究的目的是确定在存在严重胎儿酸中毒的情况下分娩的足月儿中，诸如绒毛膜羊膜炎、血管炎或脐带炎等感染/炎症组织学异常的存在或严重程度是否会增加新生儿脑病的风险。回顾了脐动脉血pH<7.00的足月儿（n = 51）的病历及胎盘病理。不良结局预先定义为出生后第一周Sarnat 2期或3期新生儿脑病或因严重脑损伤导致的新生儿死亡。与先前数据一致，严重胎儿酸血症、5分钟阿氏评分低以及需要心肺复苏与新生儿脑病显著相关。然而，组织学绒毛膜羊膜炎的存在预测价值较差，且不会增加随后发生新生儿脑病的风险。
