Amin Sanjiv B, Wang Hongyue
Division of Neonatology, Department of Pediatrics, The University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642, USA.
J Matern Fetal Neonatal Med. 2010 Oct;23(10):1165-71. doi: 10.3109/14767050903580383.
To determine if histologic chorioamnionitis is associated with acute neurologic impairment as evaluated by auditory brainstem response in premature infants.
A prospective study was performed to compare auditory neural function at birth between premature infants with maternal histologic chorioamnionitis and infants without maternal histologic chorioamnionitis. Our inclusion criteria was 28-33 weeks gestational age (GA) infants who had maternal placental histopathology performed. Infants with toxoplasmosis, other infections, rubella, cytomegalovirus and herpes simplex (TORCH) infections, chromosomal disorders, cranio-facial anomalies and/or unstable condition were excluded. Bilateral monaural auditory brainstem evoked responses were performed using 80 dB nHL click stimuli at a repetition rate of 29.9/s within 48 h after birth.
Of 101 infants who met study criteria, 29 infants were born with history of maternal histologic chorioamnionitis. There were no significant differences between infants with histologic chorioamnionitis and infants without histologic chorioamnionitis in perinatal factors except for GA, pregnancy induced hypertension, and exposure to antenatal magnesium sulphate. After controlling for confounders, histologic chorioamnionitis was not associated with prolonged absolute wave latencies I, III, and V and/or decreased frequency of mature auditory waveform compared to infants without histologic chorioamnionitis.
Histologic chorioamnionitis is not associated with neurologic impairment at birth in premature infants.
通过对早产儿进行听觉脑干反应评估，确定组织学绒毛膜羊膜炎是否与急性神经功能损害相关。
进行一项前瞻性研究，比较患有母体组织学绒毛膜羊膜炎的早产儿与未患母体组织学绒毛膜羊膜炎的早产儿出生时的听觉神经功能。我们的纳入标准是孕周为28 - 33周（GA）且进行了母体胎盘组织病理学检查的婴儿。排除患有弓形虫病、其他感染、风疹、巨细胞病毒和单纯疱疹（TORCH）感染、染色体疾病、颅面畸形和/或病情不稳定的婴儿。在出生后48小时内，使用80 dB nHL短声刺激，以29.9/s的重复率进行双侧单耳听觉脑干诱发反应。
在101名符合研究标准的婴儿中，29名婴儿出生时母亲有组织学绒毛膜羊膜炎病史。除了孕周、妊娠高血压和产前硫酸镁暴露外，有组织学绒毛膜羊膜炎的婴儿和无组织学绒毛膜羊膜炎的婴儿在围产期因素方面没有显著差异。在控制混杂因素后，与无组织学绒毛膜羊膜炎的婴儿相比，组织学绒毛膜羊膜炎与I、III和V波绝对波潜伏期延长和/或成熟听觉波形频率降低无关。
组织学绒毛膜羊膜炎与早产儿出生时的神经功能损害无关。
