Bersani Iliana, Thomas Wolfgang, Speer Christian P
University Children's Hospital, University of Würzburg, Germany.
J Matern Fetal Neonatal Med. 2012 Apr;25 Suppl 1:12-6. doi: 10.3109/14767058.2012.663161. Epub 2012 Mar 5.
Chorioamnionitis represents a major risk factor for preterm birth and contributes to prematurity-associated morbidity and mortality. Comparison of studies addressing neonatal outcome after exposure to either histological or clinical chorioamnionitis is hampered by the great heterogeneity regarding study cohorts and disease definitions which were applied. Moreover, the impact of exposure to inflammation in utero on neonatal outcome has become less evident with major advances in perinatal and neonatal care. Histologic chorioamnionitis evidently is associated with a reduction of incidence and severity of respiratory distress syndrome. Short-term maturational effects on the lungs of ventilated extremely premature infants are, however, accompanied by a greater susceptibility of the lung, eventually contributing to an increased risk of bronchopulmonary dysplasia. Chorioamnionitis has been shown associated with increased rate of early-onset sepsis but, according to recent data, histological chorioamnionitis might be protective against late-onset sepsis. Inconsistent data exist concerning the true role of chorioamnionitis in the development of brain lesions such as cystic periventricular leukomalacia, diffuse white matter disease, and intraventricular hemorrhage. However, an association with the development of cerebral palsy has been reported.
绒毛膜羊膜炎是早产的主要危险因素，会导致与早产相关的发病和死亡。由于所应用的研究队列和疾病定义存在很大异质性，比较暴露于组织学绒毛膜羊膜炎或临床绒毛膜羊膜炎后的新生儿结局的研究受到阻碍。此外，随着围产期和新生儿护理的重大进展，子宫内炎症暴露对新生儿结局的影响变得不那么明显。组织学绒毛膜羊膜炎显然与呼吸窘迫综合征的发病率和严重程度降低有关。然而，对机械通气的极早产儿肺部的短期成熟作用伴随着肺部更高的易感性，最终导致支气管肺发育不良的风险增加。绒毛膜羊膜炎已被证明与早发型败血症的发生率增加有关，但根据最近的数据，组织学绒毛膜羊膜炎可能对晚发型败血症有保护作用。关于绒毛膜羊膜炎在脑损伤如脑室周围白质软化、弥漫性白质病和脑室内出血发展中的真正作用，存在不一致的数据。然而，已有报道称其与脑瘫的发生有关。
