Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA.
Am J Reprod Immunol. 2018 Sep;80(3):e12986. doi: 10.1111/aji.12986. Epub 2018 May 24.
There is a paucity of research on the contribution of placental inflammation to severe retinopathy of prematurity (ROP).
A retrospective cohort study (n = 1217) was conducted of infants screened for ROP (2006-2016). The outcomes of the study were severe ROP (type 1 or type 2 ROP) and low grade ROP. We categorized the placental pathology as the presence of (i) maternal plus fetal inflammatory response, (ii) maternal inflammatory response only, (iii) fetal inflammatory response only and, (iv) no evidence of a maternal or fetal inflammatory response. The data were analyzed using univariate and multivariate logistic regression analyses (P < .05).
In this cohort, the number of infants with the maternal plus fetal inflammatory response, the maternal inflammatory response only, the fetal inflammatory response only, and no maternal or fetal inflammatory response was 305 (25%), 82 (7%), 8 (1%), and 822 (67%), respectively. Adjusted for covariates, the maternal plus fetal inflammatory response was a significant risk factor for severe ROP (AOR = 2.6, 95% CI 1.1-5.9, P = .03). None of the categories of placental inflammation were significantly associated with low grade ROP.
Placental pathology distinguished by the maternal plus fetal inflammatory response was a significant risk factor for severe ROP. Our study supports a link between intrauterine inflammatory events and the subsequent development of severe ROP.
关于胎盘炎症对严重早产儿视网膜病变（ROP）的贡献，研究甚少。
对 2006 年至 2016 年期间接受 ROP 筛查的婴儿进行了回顾性队列研究（n=1217）。该研究的结果为严重 ROP（1 型或 2 型 ROP）和低级别 ROP。我们将胎盘病理学分类为存在（i）母体加胎儿炎症反应、（ii）仅母体炎症反应、（iii）仅胎儿炎症反应和（iv）无母体或胎儿炎症反应的证据。使用单变量和多变量逻辑回归分析（P<.05）对数据进行分析。
在该队列中，有 305 名（25%）婴儿存在母体加胎儿炎症反应、82 名（7%）婴儿存在仅母体炎症反应、8 名（1%）婴儿存在仅胎儿炎症反应，822 名（67%）婴儿无母体或胎儿炎症反应。调整协变量后，母体加胎儿炎症反应是严重 ROP 的显著危险因素（AOR=2.6，95%CI 1.1-5.9，P=0.03）。胎盘炎症的任何类别均与低级别 ROP 无显著相关性。
通过母体加胎儿炎症反应区分的胎盘病理学是严重 ROP 的显著危险因素。我们的研究支持宫内炎症事件与随后发生严重 ROP 之间的关联。
