International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910# Hengshan Road, Shanghai, 200030, China.
International Peace Maternity and Child Health Hospital of China Welfare Institute, Shanghai, China.
BMC Pediatr. 2021 Mar 1;21(1):104. doi: 10.1186/s12887-021-02572-9.
Chorioamnionitis is associated with various neonatal short- and long-term morbidities. The effect of chorioamnionitis on premature children's outcomes remains controversial. The aim of this study is to investigate the relationship between histological chorioamnionitis (HCA) and physiological development, wheezing, and atopic diseases in preterm children.
Singleton, preterm children (< 34 weeks), whose mother underwent pathological placental examinations, were retrospectively enrolled and the outcomes were assessed at 24-40 months during follow-up. Wheezing and atopic diseases including eczema, food allergies, and allergic rhinitis were screened by a questionnaire along with medical diagnosis. Anthropometric indexes and blood pressure were measured. Cognitive and behavioural developments were assessed by the Gesell Development and Diagnosis Scale. Blood IgE and routine examination were analyzed with venous blood and serum metabolomic profiling was assessed via liquid chromatography-mass spectrometry (LC-MS). A multivariate logistic regression model was used to estimate the association between HCA and the current outcomes.
Among the 115 enrolled children, 47 were exposed to HCA. The incidence of wheezing was significantly higher in children exposed to HCA, as 38.30% of children who were exposed to HCA and 16.18% of children who were not had been diagnosed with wheezing. After adjusting for related confounders in the multivariate logistic regression model, there remained a 2.72-fold increased risk of wheezing in children with HCA (adjusted odds ratio, aOR, 2.72; 95% confidence interval, 1.02-7.23). Moreover, 163 differential metabolites, such as butanoic acid, annotemoyin 1 and charine, were identified in the HCA exposed children's serum. Enrichment analysis revealed that these compounds participated in diverse key metabolomic pathways relating to physical and neuro- developments, including glycerophospholipid, alpha-linolenic acid and choline metabolisms. There were no significant differences in atopic diseases, serum IgE, eosinophils' level, anthropometric indexes, blood pressure, or cognitive or behavioural developments between the two groups.
HCA exposure is associated with an increased risk of wheezing in preterm children less than 34 gestational weeks.
绒毛膜羊膜炎与新生儿各种短期和长期的发病率有关。绒毛膜羊膜炎对早产儿结局的影响仍存在争议。本研究旨在探讨组织学绒毛膜羊膜炎（HCA）与早产儿生理发育、喘息和特应性疾病的关系。
回顾性纳入了 115 名接受病理性胎盘检查的单胎、早产（<34 周）儿童，并在随访的 24-40 个月时评估其结局。通过问卷调查和医疗诊断筛查喘息和特应性疾病，包括特应性皮炎、食物过敏和过敏性鼻炎。测量体格发育指标和血压。采用 Gesell 发育和诊断量表评估认知和行为发育。通过静脉血分析血 IgE 和常规检查，通过液相色谱-质谱（LC-MS）评估血清代谢组学谱。采用多变量逻辑回归模型估计 HCA 与当前结局的关系。
在纳入的 115 名儿童中，47 名儿童暴露于 HCA。暴露于 HCA 的儿童喘息发生率明显较高，38.30%的暴露于 HCA 的儿童和 16.18%的未暴露于 HCA 的儿童被诊断为喘息。在多变量逻辑回归模型中调整相关混杂因素后，HCA 儿童喘息的风险仍增加 2.72 倍（调整优势比，aOR，2.72；95%置信区间，1.02-7.23）。此外，在暴露于 HCA 的儿童的血清中鉴定出 163 种差异代谢物，如丁酸、 annotemoyin 1 和 charine。富集分析显示，这些化合物参与了与生理和神经发育相关的多种关键代谢途径，包括甘油磷脂、α-亚麻酸和胆碱代谢。两组间特应性疾病、血清 IgE、嗜酸性粒细胞水平、体格发育指标、血压、认知或行为发育无显著差异。
暴露于 HCA 与 34 周以下的早产儿喘息风险增加有关。
