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组织学绒毛膜羊膜炎对极低出生体重儿产后生长的影响。

Impact of histological chorioamnionitis on postnatal growth in very-low birth weight infants.

机构信息

Neonatology Department, Hospital Sant Joan de Déu, BCNatal, Institut de Reçerca Sant Joan de Déu, Barcelona, Spain.

Hospital Clinic, BCNatal, Universitat de Barcelona, Barcelona, Spain.

出版信息

J Matern Fetal Neonatal Med. 2021 Jun;34(11):1780-1785. doi: 10.1080/14767058.2019.1648423. Epub 2019 Aug 1.

Abstract

BACKGROUND

Postnatal growth restriction remains one of the most common problems of very preterm infants (VPI). Chorioamnionitis is a frequent cause of prematurity. Both have been related to worse postnatal outcomes.

OBJECTIVES

To evaluate the influence of histological chorioamnionitis (CA) on postnatal growth in very premature infants.

METHODS

Retrospective one-to-one matched cohort study assessing growth in infants born at or below 32.0 weeks gestation from mothers for whom histological examination of the placenta was available. Newborns with histological CA were matched and compared with those without it. Postnatal growth was recorded at admission, 14 days of life, 28 days of life and 36 weeks postmenstrual age (PMA). Nutritional support and clinical outcomes were used as covariables.

RESULTS

Eighty-eight patients were included: 44 with fetal or/and maternal placental inflammation, and 44 without histological CA (41% with vasculopathy findings and 59% without). Baseline characteristics were similar between the groups. Change in weight z-scores at 14 days of life, 28 days of life, 36 weeks PMA or at discharge were similar in both groups, with a steady fall and no signs of catch-up. No differences were found in enteral and parenteral nutritional intakes between groups.

CONCLUSIONS

Histological CA did not affect postnatal growth of very preterm infants after matching for birth weight z-scores with non-CA newborns.

摘要

背景

出生后生长受限仍然是极早产儿(VPI)最常见的问题之一。绒毛膜羊膜炎是早产的常见原因。两者都与较差的出生后结局有关。

目的

评估组织学绒毛膜羊膜炎(CA)对极早产儿出生后生长的影响。

方法

这是一项回顾性 1:1 匹配队列研究,评估了胎盘组织学检查可用的母亲分娩的 32.0 周及以下胎龄婴儿的生长情况。将患有组织学 CA 的新生儿与无 CA 的新生儿进行匹配和比较。在入院时、14 天、28 天和 36 周校正胎龄(PMA)时记录生长情况。营养支持和临床结局用作协变量。

结果

共纳入 88 例患者:44 例胎儿和/或母体胎盘炎症,44 例无组织学 CA(41%有血管病变发现,59%无)。两组的基线特征相似。两组在第 14 天、第 28 天、36 周 PMA 或出院时体重 z 评分的变化相似,呈持续下降,没有追赶生长的迹象。两组之间肠内和肠外营养摄入量没有差异。

结论

在与非 CA 新生儿匹配出生体重 z 评分后,组织学 CA 并没有影响极早产儿的出生后生长。

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