Hecht Jonathan L, Onderdonk Andrew, Delaney Mary, Allred Elizabeth N, Kliman Harvey J, Zambrano Eduardo, Pflueger Solveig M, Livasy Chad A, Bhan Ina, Leviton Alan
Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Pediatr Dev Pathol. 2008 Jan-Feb;11(1):15-22. doi: 10.2350/07-06-0285.1.
Prolonged exposure to infection appears to influence fetal/neonatal development. We characterize the relationship between histologic patterns of inflammation and microorganism recovery from the placentas of live born infants delivered before the 28th postmenstrual week. The subamniotic parenchyma of 835 placentas delivered by cesarean section were cultured and evaluated for specific histologic patterns of inflammation in a blinded fashion. Cases with prolonged membrane rupture were excluded. Microorganisms were recovered from 41% of placentas. Microorganisms found more frequently in placentas with high-grade chorionic plate inflammation include Actinomyces, Prevotella bivia, Corynebacterium sp., Escherichia coli, Peptostreptococcus magnus, multiple species of Streptococci, and Mycoplasma sp., including Ureaplasma urealyticum. These microorganisms were also associated with fetal vasculitis (neutrophilic infiltration of chorionic plate stem vessels or umbilical cord). Recovery of microorganisms from placental parenchyma is associated with histologic inflammation. The same microorganisms responsible for inciting high-grade chorionic plate inflammation are also most likely to promote fetal inflammation.
长期暴露于感染似乎会影响胎儿/新生儿的发育。我们描述了炎症组织学模式与从月经周期第28周前出生的活产婴儿胎盘分离出的微生物之间的关系。对835例剖宫产分娩的胎盘羊膜下实质进行培养，并以盲法评估炎症的特定组织学模式。排除胎膜早破时间延长的病例。41%的胎盘分离出了微生物。在伴有重度绒毛膜板炎症的胎盘中更常见的微生物包括放线菌、二路普雷沃菌、棒状杆菌属、大肠杆菌、大消化链球菌、多种链球菌以及支原体属，包括解脲脲原体。这些微生物还与胎儿血管炎（绒毛膜板主干血管或脐带的中性粒细胞浸润）有关。从胎盘实质中分离出微生物与组织学炎症有关。引发重度绒毛膜板炎症的相同微生物也最有可能促进胎儿炎症。
