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本文引用的文献

1
Association between preterm brain injury and exposure to chorioamnionitis during fetal life.胎儿期绒毛膜羊膜炎与早产儿脑损伤的关系。
Sci Rep. 2016 Dec 1;6:37932. doi: 10.1038/srep37932.
2
Neonatal Brain Tissue Classification with Morphological Adaptation and Unified Segmentation.基于形态学适应和统一分割的新生儿脑组织分类
Front Neuroinform. 2016 Mar 29;10:12. doi: 10.3389/fninf.2016.00012. eCollection 2016.
3
Moderate and late preterm birth: effect on brain size and maturation at term-equivalent age.中度和晚期早产儿:对足月时大脑大小和成熟度的影响。
Radiology. 2014 Oct;273(1):232-40. doi: 10.1148/radiol.14132410. Epub 2014 Jun 10.
4
Neurobehaviour between birth and 40 weeks' gestation in infants born <30 weeks' gestation and parental psychological wellbeing: predictors of brain development and child outcomes.早产儿(<30 周)出生至 40 孕周期间的神经行为与父母心理福祉:脑发育和儿童结局的预测因素。
BMC Pediatr. 2014 Apr 24;14:111. doi: 10.1186/1471-2431-14-111.
5
Chorioamnionitis in the pathogenesis of brain injury in preterm infants.绒毛膜羊膜炎在早产儿脑损伤发病机制中的作用
Clin Perinatol. 2014 Mar;41(1):83-103. doi: 10.1016/j.clp.2013.10.009. Epub 2013 Dec 12.
6
Fetal immune response to chorioamnionitis.胎儿对绒毛膜羊膜炎的免疫反应。
Semin Reprod Med. 2014 Jan;32(1):56-67. doi: 10.1055/s-0033-1361823. Epub 2014 Jan 3.
7
Acute histologic chorioamnionitis is a risk factor for adverse neonatal outcome in late preterm birth after preterm premature rupture of membranes.急性组织学绒毛膜羊膜炎是胎膜早破后晚期早产新生儿不良结局的一个危险因素。
PLoS One. 2013 Dec 4;8(12):e79941. doi: 10.1371/journal.pone.0079941. eCollection 2013.
8
New MR imaging assessment tool to define brain abnormalities in very preterm infants at term.新的磁共振成像评估工具可在足月时定义极早产儿的脑异常。
AJNR Am J Neuroradiol. 2013 Nov-Dec;34(11):2208-14. doi: 10.3174/ajnr.A3521. Epub 2013 Apr 25.
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Increasing rates of prematurity and epidemiology of late preterm birth.早产率上升及晚期早产的流行病学情况。
J Paediatr Child Health. 2012 Sep;48(9):784-8. doi: 10.1111/j.1440-1754.2012.02536.x.
10
Chorioamnionitis--the good or the evil for neonatal outcome?绒毛膜羊膜炎——对新生儿结局是福还是祸?
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早产儿组织学绒毛膜羊膜炎:与足月等效年龄时脑磁共振成像的相关性

Histologic chorioamnionitis in preterm infants: correlation with brain magnetic resonance imaging at term equivalent age.

作者信息

Granger Claire, Spittle Alicia J, Walsh Jennifer, Pyman Jan, Anderson Peter J, Thompson Deanne K, Lee Katherine J, Coleman Lee, Dagia Charuta, Doyle Lex W, Cheong Jeanie

机构信息

Department of Neonatal Medicine, Royal Children's Hospital, Melbourne, Australia.

Neonatal Intensive Care Unit, Princess Royal Maternity Hospital, 16 Alexandra Parade, Glasgow, G31 2ER, Scotland.

出版信息

BMC Pediatr. 2018 Feb 15;18(1):63. doi: 10.1186/s12887-018-1001-6.

DOI:10.1186/s12887-018-1001-6
PMID:29448926
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5815189/
Abstract

BACKGROUND

To explore the associations between histologic chorioamnionitis with brain injury, maturation and size on magnetic resonance imaging (MRI) of preterm infants at term equivalent age.

METHODS

Preterm infants (23-36 weeks' gestational age) were recruited into two longitudinal cohort studies. Presence or absence of chorioamnionitis was obtained from placental histology and clinical data were recorded. MRI at term-equivalent age was assessed for brain injury (intraventricular haemorrhage, cysts, signal abnormalities), maturation (degree of myelination, gyral maturation) and size of cerebral structures (metrics and brain segmentation). Histologic chorioamnionitis was assessed as a predictor of MRI variables using linear and logistic regression, with adjustment for confounding perinatal variables.

RESULTS

Two hundred and twelve infants were included in this study, 47 (22%) of whom had histologic chorioamnionitis. Histologic chorioamnionitis was associated with higher odds of intraventricular haemorrhage (odds ratio [OR] (95% confidence interval [CI]) = 7.4 (2.4, 23.1)), less mature gyral maturation (OR (95% CI) = 2.0 (1.0, 3.8)) and larger brain volume (mean difference in cubic centimeter (95% CI) of 14.1 (1.9, 26.2)); but all relationships disappeared following adjustment for perinatal variables.

CONCLUSION

Histologic chorioamnionitis was not independently associated with IVH, less mature gyral maturation or brain volume at term-equivalent age in preterm infants.

摘要

背景

探讨组织学绒毛膜羊膜炎与足月相当年龄早产儿脑损伤、成熟度及磁共振成像(MRI)测量的脑大小之间的关联。

方法

将孕周为23 - 36周的早产儿纳入两项纵向队列研究。从胎盘组织学检查中获取是否存在绒毛膜羊膜炎,并记录临床数据。对足月相当年龄时的MRI进行评估,观察脑损伤(脑室内出血、囊肿、信号异常)、成熟度(髓鞘形成程度、脑回成熟度)以及脑结构大小(测量指标和脑分割)。采用线性和逻辑回归分析评估组织学绒毛膜羊膜炎作为MRI变量的预测因素,并对围产期混杂变量进行校正。

结果

本研究共纳入212例婴儿,其中47例(22%)有组织学绒毛膜羊膜炎。组织学绒毛膜羊膜炎与脑室内出血几率较高相关(优势比[OR](95%置信区间[CI]) = 7.4(2.4,23.1))、脑回成熟度较低(OR(95%CI) = 2.0(1.0,3.8))以及脑体积较大(立方厘米平均差值(95%CI)为14.1(1.9,26.2));但在校正围产期变量后,所有这些关系均消失。

结论

组织学绒毛膜羊膜炎与足月相当年龄早产儿的脑室内出血、脑回成熟度较低或脑体积无独立关联。