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组织学绒毛膜羊膜炎和产前类固醇对小于 34 孕周早产儿新生儿结局的影响。

The association of histological chorioamnionitis and antenatal steroids on neonatal outcome in preterm infants born at less than thirty-four weeks' gestation.

机构信息

Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea.

出版信息

Neonatology. 2012;102(4):259-64. doi: 10.1159/000339577. Epub 2012 Aug 17.

Abstract

BACKGROUND

Despite continuous research on the prevention of preterm labor, preterm delivery still occurs often. Different neonatal outcomes in association with chorioamnionitis might occur with the introduction of antenatal steroids.

OBJECTIVE

The purpose of this study was to determine the effect of chorioamnionitis on the outcome of preterm infants and the association of antenatal steroids in the presence of histological chorioamnionitis (HC).

METHODS

Two hundred and fifty-seven infants born at <34 weeks and admitted to Ewha Womans University Hospital from 2005 to 2010 were enrolled. They were divided into 2 groups, one with HC (n = 89) and the other without HC (n = 168). The clinical characteristics and outcomes of the preterm infants including sepsis, respiratory distress syndrome, intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD) were analyzed.

RESULTS

HC was associated with IVH (p = 0.019) and early-onset sepsis (p = 0.038). In the HC group, the infants exposed to antenatal steroids developed BPD less than those without steroid exposure. The duration of mechanical ventilation was significantly decreased in the group with antenatal steroids.

CONCLUSION

HC increased the incidence of early-onset sepsis and IVH in preterm infants of less than 34 weeks' gestation with a high odds ratio of 9.54. In the presence of HC, antenatal steroids significantly decreased the incidence of BPD.

摘要

背景

尽管对预防早产进行了持续研究,但早产仍经常发生。绒毛膜羊膜炎可能会导致不同的新生儿结局,而产前类固醇的应用可能与之相关。

目的

本研究旨在确定绒毛膜羊膜炎对早产儿结局的影响,以及在存在组织学绒毛膜羊膜炎(HC)的情况下产前类固醇的相关性。

方法

2005 年至 2010 年期间,共纳入 257 名胎龄<34 周、入住延世大学峨山医院的婴儿。将他们分为两组,一组有 HC(n=89),另一组没有 HC(n=168)。分析早产儿的临床特征和结局,包括败血症、呼吸窘迫综合征、颅内出血(IVH)和支气管肺发育不良(BPD)。

结果

HC 与 IVH(p=0.019)和早发性败血症(p=0.038)相关。在 HC 组中,接受产前类固醇治疗的婴儿发生 BPD 的风险低于未接受类固醇治疗的婴儿。接受产前类固醇治疗的婴儿机械通气时间明显缩短。

结论

HC 增加了胎龄<34 周的早产儿早发性败血症和 IVH 的发生率,其优势比为 9.54。在存在 HC 的情况下,产前类固醇显著降低了 BPD 的发生率。

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