Women and Babies Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Am J Perinatol. 2013 Jan;30(1):59-68. doi: 10.1055/s-0032-1321501. Epub 2012 Jul 6.
Chorioamnionitis contributes to neonatal and maternal morbidity and mortality. We aimed to evaluate of the impact of clinical and histological chorioamnionitis on mortality and morbidity of preterm infants. Maternal and neonatal data were collected in a retrospective cohort of preterm infants less than 30 weeks' gestation. Infants were divided into three groups: those born to mothers with clinical chorioamnionitis, histological chorioamnionitis, or no chorioamnionitis. Of 274 identified preterm infants, 33 infants were born to mothers with clinical chorioamnionitis, 95 to mothers with histological chorioamnionitis, and 146 to mothers with no chorioamnionitis. Data were available for 180 (78%) of the 230 survivors at 18 months corrected age. Infants in the study groups were similar in gestational age, birth weight, and sex distribution. Clinical and histological chorioamnionitis were not predictive of infant mortality, cerebral palsy, bronchopulmonary dysplasia, periventricular leukomalacia, or retinopathy of prematurity. Infants in the clinical chorioamnionitis group had significantly lower cognitive (88 ± 10), language (82 ± 12), and motor (89 ± 11) scores compared with infants in the histological chorioamnionitis group (101 ± 13, p < 0.01; 91 ± 13, p < 0.05; and 99 ± 13, p < 0.05, respectively) and to infants in the no chorioamnionitis group (99 ± 13, p < 0.01; 92 ± 15, p < 0.05; and 97 ± 13, p < 0.05, respectively). Clinical chorioamnionitis is associated with developmental delay in preterm infants despite adequate treatment.
绒毛膜羊膜炎导致新生儿和产妇发病率和死亡率升高。我们旨在评估临床和组织学绒毛膜羊膜炎对早产儿发病率和死亡率的影响。本研究回顾性收集了小于 30 孕周的早产儿的母婴数据。将婴儿分为三组：母亲患有临床绒毛膜羊膜炎、组织学绒毛膜羊膜炎和无绒毛膜羊膜炎的婴儿。在确定的 274 例早产儿中，有 33 例婴儿的母亲患有临床绒毛膜羊膜炎，95 例婴儿的母亲患有组织学绒毛膜羊膜炎，146 例婴儿的母亲无绒毛膜羊膜炎。在 18 个月的校正年龄时，有 230 名存活婴儿中的 180 名（78%）可获得数据。研究组的婴儿在胎龄、出生体重和性别分布上相似。临床和组织学绒毛膜羊膜炎与婴儿死亡率、脑瘫、支气管肺发育不良、脑室周围白质软化或早产儿视网膜病变无关。临床绒毛膜羊膜炎组婴儿的认知（88 ± 10）、语言（82 ± 12）和运动（89 ± 11）评分显著低于组织学绒毛膜羊膜炎组（101 ± 13，p < 0.01；91 ± 13，p < 0.05；99 ± 13，p < 0.05）和无绒毛膜羊膜炎组（99 ± 13，p < 0.01；92 ± 15，p < 0.05；97 ± 13，p < 0.05）。尽管治疗得当，临床绒毛膜羊膜炎仍与早产儿发育迟缓有关。
