两种临床绒毛膜羊膜炎定义在预测新生儿感染结局中的效用：一项系统评价

Usefulness of two clinical chorioamnionitis definitions in predicting neonatal infectious outcomes: a systematic review.

作者信息

Avila Cecilia, Willins Jennifer L, Jackson Matthew, Mathai Jacob, Jabsky Marina, Kong Alex, Callaghan Fiona, Ishkin Selda, Shroyer A Laurie W

机构信息

Department of Obstetrics, Gynecology, and Reproductive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.

U.S. Food and Drug Administration, CDER/OTS/OB/DB6, Silver Spring, Maryland.

出版信息

Am J Perinatol. 2015 Sep;32(11):1001-9. doi: 10.1055/s-0035-1547325. Epub 2015 May 22.

DOI:10.1055/s-0035-1547325

PMID:26007317

Abstract

OBJECTIVE

To assess the usefulness of two definitions of acute clinical chorioamnionitis (ACCA) in predicting risk of neonatal infectious outcomes (NIO) and mortality, the first definition requiring maternal fever alone (Fever), and the second requiring ≥ 1 Gibbs criterion besides fever (Fever + 1).

STUDY DESIGN

PubMed, Web of Science, and the Cochrane Database of Systematic Reviews were searched from January 1, 1979 to April 9, 2013. Twelve studies were reviewed (of 316 articles identified): three studies with term patients, four with preterm premature rupture of membranes (PPROM) patients, and five mixed studies with mixed gestational ages and/or membrane status (intact and/or ruptured).

RESULTS

Both definitions demonstrated an increased NIO risk for ACCA versus non-ACCA patients, with an odds ratio increase for the Fever + 1 definition that was about twofold larger than the Fever definition.

CONCLUSION

As the Fever definition demonstrated increased NIO risk for ACCA versus non-ACCA patients, the Fever alone ACCA definition should be used to trigger future clinical treatment in many clinical situations.

摘要