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早产儿和小于胎龄儿的胎盘病理学和脑室出血。

Placental pathology and intraventricular hemorrhage in preterm and small for gestational age infants.

机构信息

Department of Neonatology, Children's National Hospital, Washington, DC, USA.

Department of Pediatrics, Division of Neonatology, Beverly Knight Olson Children's Hospital Navicent Health, Macon, GA, USA.

出版信息

J Perinatol. 2021 Apr;41(4):843-849. doi: 10.1038/s41372-021-00954-6. Epub 2021 Mar 1.

DOI:10.1038/s41372-021-00954-6
PMID:33649433
Abstract

OBJECTIVE

The aim of this study was to examine the relationship between chorioamnionitis and vascular malperfusion on placental pathology and intraventricular hemorrhage (IVH) in premature and small for gestational age (SGA) infants.

STUDY DESIGN

A retrospective analysis of 263 infants ≤34 weeks gestation or ≤1800 g and their mothers was conducted by chart review for placental pathology and clinical data from 2014 to 2018. Unadjusted and adjusted odds ratios (OR) for the association of placental pathology with IVH were calculated.

RESULT

Unadjusted OR showed an association between acute chorioamnionitis and IVH, but logistic regression analysis showed a non-significant adjusted OR between acute or chronic chorioamnionitis with IVH. Maternal vascular malperfusion was significantly associated with increased IVH when controlling for confounders.

CONCLUSION

Placental maternal vascular malperfusion is associated with the development of IVH in premature and SGA infants when controlling for other confounders.

摘要

目的

本研究旨在探讨绒毛膜羊膜炎与血管灌注不良在早产儿和小于胎龄儿(SGA)脑室内出血(IVH)中的关系。

研究设计

对 2014 年至 2018 年期间 263 名胎龄≤34 周或体重≤1800g 的婴儿及其母亲的病历进行回顾性分析,以评估胎盘病理和临床数据。计算胎盘病理与 IVH 之间的关联的未调整和调整比值比(OR)。

结果

未调整的 OR 显示急性绒毛膜羊膜炎与 IVH 之间存在关联,但 logistic 回归分析显示急性或慢性绒毛膜羊膜炎与 IVH 之间的调整 OR 无统计学意义。在控制混杂因素后,母体血管灌注不良与 IVH 的发生显著相关。

结论

在控制其他混杂因素后,胎盘母体血管灌注不良与早产儿和 SGA 婴儿 IVH 的发生有关。

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本文引用的文献

1
Chorioamnionitis Is a Risk Factor for Intraventricular Hemorrhage in Preterm Infants: A Systematic Review and Meta-Analysis.绒毛膜羊膜炎是早产儿脑室内出血的一个危险因素:一项系统评价和荟萃分析。
Front Physiol. 2018 Sep 11;9:1253. doi: 10.3389/fphys.2018.01253. eCollection 2018.
2
Sampling and Definitions of Placental Lesions: Amsterdam Placental Workshop Group Consensus Statement.胎盘病变的采样与定义:阿姆斯特丹胎盘研讨会小组共识声明
Arch Pathol Lab Med. 2016 Jul;140(7):698-713. doi: 10.5858/arpa.2015-0225-CC. Epub 2016 May 25.
3
Correlation of preterm infant illness severity with placental histology.
早产儿疾病严重程度与胎盘组织学的相关性。
Placenta. 2016 Mar;39:61-9. doi: 10.1016/j.placenta.2016.01.012. Epub 2016 Jan 16.
4
Genes and environment in neonatal intraventricular hemorrhage.新生儿脑室内出血中的基因与环境
Semin Perinatol. 2015 Dec;39(8):592-603. doi: 10.1053/j.semperi.2015.09.006. Epub 2015 Oct 26.
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Classification of placental lesions.胎盘病变的分类。
Am J Obstet Gynecol. 2015 Oct;213(4 Suppl):S21-8. doi: 10.1016/j.ajog.2015.05.056.
6
The Human Placenta Project: placental structure, development, and function in real time.人类胎盘项目:实时观察胎盘的结构、发育及功能。
Placenta. 2014 May;35(5):303-4. doi: 10.1016/j.placenta.2014.02.012. Epub 2014 Mar 6.
7
Placental pathology, perinatal death, neonatal outcome, and neurological development: a systematic review.胎盘病理学、围产期死亡、新生儿结局及神经发育:一项系统综述
PLoS One. 2014 Feb 25;9(2):e89419. doi: 10.1371/journal.pone.0089419. eCollection 2014.
8
Pregnancy disorders leading to very preterm birth influence neonatal outcomes: results of the population-based ACTION cohort study.导致极早产的妊娠疾病会影响新生儿结局:基于人群的 ACTION 队列研究结果。
Pediatr Res. 2013 Jun;73(6):794-801. doi: 10.1038/pr.2013.52. Epub 2013 Mar 14.
9
Systemic inflammation, intraventricular hemorrhage, and white matter injury.全身炎症、脑室内出血和白质损伤。
J Child Neurol. 2013 Dec;28(12):1637-45. doi: 10.1177/0883073812463068. Epub 2012 Oct 30.
10
Patterns of placental pathology in preterm infants with a periventricular haemorrhagic infarction: association with time of onset and clinical presentation.早产儿伴脑室周围出血性梗死的胎盘病理模式:与发病时间和临床表现的关系。
Placenta. 2012 Oct;33(10):839-44. doi: 10.1016/j.placenta.2012.06.014. Epub 2012 Jul 25.