O'Brien James M, Santolaya Jacobo L, Palomares Kristy, Blitzer David, Santolaya-Forgas Joaquin
Penn State Milton S. Hershey Medical Center, Division of Maternal Fetal Medicine, Hershey, PA, USA.
Children's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, PA, USA.
J Perinat Med. 2018 Oct 25;46(8):839-844. doi: 10.1515/jpm-2017-0043.
Objective To evaluate the possible association between antenatal magnesium sulfate treatment with histological chorioamnionitis in patients with singleton or dichorionic twins that had preterm premature rupture of the membranes. Methods This was an observational study performed in patients admitted to the hospital with rupture of membranes before 34 weeks' gestation. The primary outcome was histological chorioamnionitis and the primary predictor was antenatal magnesium sulfate treatment. A logistic regression model was used without consideration of other antenatal medical treatments. Results Among 107 patients with preterm deliveries, 57 were admitted to the hospital before 34 weeks' gestation with preterm premature rupture of membranes. Fifty-cases were excluded from the analysis because they were admitted after 34 weeks' gestation, delivered before 24 weeks' gestation or had intrauterine fetal demise or monochorionic twins. The logistic regression analysis adjusting for maternal age, gravidity, parity, multiple gestation, gestational age at delivery, and birthweight, indicated that patients with singleton pregnancies and histological chorioamnionitis had received magnesium sulfate antenatally more frequently (χ2=6.46; P=0.01). The association between histological chorioamnionitis and magnesium sulfate treatment was not found among patients with dichorionic twin pregnancies with one intact gestational sac. Conclusions In this cohort of patients with preterm premature rupture of membranes admitted to the hospital before 34 week's gestation, those with singleton pregnancies treated antenatally with magnesium sulfate for neonatal neuroprotection had a greater rate of histological chorioamnionitis.
目的 评估单胎或双绒毛膜双胎胎膜早破患者产前硫酸镁治疗与组织学绒毛膜羊膜炎之间可能存在的关联。方法 这是一项对妊娠34周前胎膜破裂入院患者进行的观察性研究。主要结局是组织学绒毛膜羊膜炎，主要预测因素是产前硫酸镁治疗。使用逻辑回归模型，未考虑其他产前医学治疗。结果 在107例早产患者中，57例在妊娠34周前因胎膜早破入院。50例被排除在分析之外，因为他们在妊娠34周后入院、在妊娠24周前分娩或有宫内胎儿死亡或单绒毛膜双胎。经产妇年龄、孕次、产次、多胎妊娠、分娩时孕周和出生体重校正后的逻辑回归分析表明，单胎妊娠且有组织学绒毛膜羊膜炎的患者产前更频繁接受硫酸镁治疗（χ2=6.46；P=0.01）。在有一个完整妊娠囊的双绒毛膜双胎妊娠患者中未发现组织学绒毛膜羊膜炎与硫酸镁治疗之间的关联。结论 在这组妊娠34周前胎膜早破入院的患者中，产前接受硫酸镁治疗以保护新生儿神经的单胎妊娠患者组织学绒毛膜羊膜炎发生率更高。
