Horvath Boldizsár, Lakatos Ferenc, Tóth Csaba, Bödecs Tamás, Bódis József
J Perinat Med. 2014 Jul;42(4):441-7. doi: 10.1515/jpm-2013-0186.
To assess neonatal outcomes and associated findings in pregnant women identified after delivery as having had underlying subclinical chorioamnionitis by either histology or bacterial culture.
In 16 years, 8974 clinical, histological, and bacterial culture data were obtained retrospectively.
Placental histology was analyzed in 4237 pregnancies (2785 term and 1452 preterm) and 4737 amniotic cavity cultures were obtained during 5446 cesarean deliveries (3268 term and 1469 preterm). Histological results and bacterial cultures were both available in 1270 of the preterm deliveries. Histology revealed inflammation, suggestive of infection, in 13.6% of placentas. Subclinical acute chorioamnionic inflammation was confirmed in 142 out of 2785 term pregnancies (5.1%) and in 436 out of 1452 preterm pregnancies (30.0%, P<0.001). Bacteriological culture of the intrauterine cavity was obtained from the lower uterine segment of the uterus during cesarean section. A positive culture was found in 19.9% of all cases (941/4737), this proportion was significantly higher in preterm deliveries (343/1273, 26.9%) than in term (17.3%, P<0.001). The lower the birth-weight or gestational age, the higher the frequency of silent infections in the uterine cavity.
Our study findings support the association between intra-amniotic infections and preterm delivery.
评估分娩后经组织学或细菌培养确诊为潜在亚临床绒毛膜羊膜炎的孕妇的新生儿结局及相关发现。
回顾性收集16年中8974例临床、组织学和细菌培养数据。
对4237例妊娠（2785例足月妊娠和1452例早产妊娠）的胎盘组织学进行了分析，并在5446例剖宫产（3268例足月妊娠和1469例早产妊娠）过程中获取了4737份羊膜腔培养物。1270例早产分娩的组织学结果和细菌培养结果均可用。组织学显示13.6%的胎盘存在提示感染的炎症。在2785例足月妊娠中有142例（5.1%）确诊为亚临床急性绒毛膜羊膜炎，在1452例早产妊娠中有436例（30.0%，P<0.001）。剖宫产时从子宫下段获取宫腔细菌培养物。所有病例中19.9%（941/4737）培养结果为阳性，该比例在早产分娩中（343/1273，26.9%）显著高于足月分娩（17.3%，P<0.001）。出生体重或孕周越低，宫腔隐匿性感染的发生率越高。
我们的研究结果支持羊膜腔内感染与早产之间的关联。
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