组织学绒毛膜羊膜炎和支气管肺发育不良：一项回顾性队列研究。

Histological chorioamnionitis and bronchopulmonary dysplasia: a retrospective cohort study.

机构信息

Department of Pediatrics and Alberta Children's Hospital Research Institute for Child and Maternal Health, University of Calgary, Calgary, AT, Canada.

出版信息

J Perinatol. 2013 Jun;33(6):441-5. doi: 10.1038/jp.2012.154. Epub 2012 Dec 13.

DOI:10.1038/jp.2012.154

PMID:23238570

Abstract

OBJECTIVE

To examine the association between histological chorioamnionitis (HC) with or without fetal inflammatory response (FIR) and bronchopulmonary dysplasia (BPD) in preterm infants.

STUDY DESIGN

We conducted a retrospective cohort study of infants born at <29 weeks gestation admitted to the neonatal intensive care unit from 2000 to 2006, who had placental histology. We compared the incidence of BPD among three groups: No HC group, HC without FIR group and HC with FIR group. The multivariable model based on generalized estimating equation was fitted to estimate the adjusted risk ratios (aRR) and 95% confidence intervals (CIs) for BPD and combined outcome of BPD or death.

RESULT

Of 529 infants, 84 (16%) had HC without FIR, 186 (35%) had HC with FIR and 259 (49%) had no HC. Compared with the no HC group, HC with and without FIR group infants were of lower gestational age and singleton births. Multivariable modeling based on generalized estimating equation revealed that HC with FIR is associated with decreased risk of both BPD (aRR 0.88, 95% CI 0.81 to 0.95) and the combined outcome of BPD or death (aRR 0.91, 95% CI 0.86 to 0.97). HC without FIR showed a trend toward reduction in BPD (aRR 0.93, 95% CI 0.86 to 1.00).

CONCLUSIONS

HC with FIR is associated with decreased risk of both BPD and the combined outcome of BPD or death in preterm infants.

摘要

目的

探讨伴有或不伴有胎儿炎症反应（FIR）的组织学绒毛膜羊膜炎（HC）与早产儿支气管肺发育不良（BPD）的关系。

研究设计

我们对 2000 年至 2006 年期间在新生儿重症监护病房（NICU）住院的胎龄<29 周的婴儿进行了一项回顾性队列研究，这些婴儿均有胎盘组织学检查。我们比较了三组 BPD 的发生率：无 HC 组、无 FIR 的 HC 组和有 FIR 的 HC 组。基于广义估计方程的多变量模型用于估计 BPD 和 BPD 或死亡联合结局的调整风险比（aRR）和 95%置信区间（CI）。

结果

在 529 名婴儿中，84 名（16%）患有无 FIR 的 HC，186 名（35%）患有有 FIR 的 HC，259 名（49%）无 HC。与无 HC 组相比，有 FIR 的 HC 组和无 FIR 的 HC 组婴儿的胎龄和单胎出生比例较低。基于广义估计方程的多变量模型显示，有 FIR 的 HC 与 BPD（aRR 0.88，95%CI 0.81 至 0.95）和 BPD 或死亡联合结局（aRR 0.91，95%CI 0.86 至 0.97）的风险降低相关。无 FIR 的 HC 显示出降低 BPD 风险的趋势（aRR 0.93，95%CI 0.86 至 1.00）。