Division of Neonatology, Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA.
Perinatal Institute, Department of Pedaitrics, Cincinnati Children's Hospital, Cincinnati, OH, USA.
Pediatr Res. 2022 Jan;91(2):289-296. doi: 10.1038/s41390-021-01633-0. Epub 2021 Jul 1.
Chorioamnionitis or intrauterine inflammation is a frequent cause of preterm birth. Chorioamnionitis can affect almost every organ of the developing fetus. Multiple microbes have been implicated to cause chorioamnionitis, but "sterile" inflammation appears to be more common. Eradication of microorganisms has not been shown to prevent the morbidity and mortality associated with chorioamnionitis as inflammatory mediators account for continued fetal and maternal injury. Mounting evidence now supports the concept that the ensuing neonatal immune dysfunction reflects the effects of inflammation on immune programming during critical developmental windows, leading to chronic inflammatory disorders as well as vulnerability to infection after birth. A better understanding of microbiome alterations and inflammatory dysregulation may help develop better treatment strategies for infants born to mothers with chorioamnionitis.
绒毛膜羊膜炎或宫内炎症是早产的常见原因。绒毛膜羊膜炎几乎可影响发育中胎儿的每一个器官。已有多种微生物被认为可引起绒毛膜羊膜炎,但“无菌”炎症似乎更为常见。消除微生物并未显示可预防与绒毛膜羊膜炎相关的发病率和死亡率,因为炎症介质导致持续的胎儿和母体损伤。越来越多的证据支持这样一种观点,即随后的新生儿免疫功能障碍反映了炎症对关键发育窗口期免疫编程的影响,导致慢性炎症性疾病以及出生后易感染。更好地了解微生物组的改变和炎症失调可能有助于为患有绒毛膜羊膜炎的母亲所生的婴儿制定更好的治疗策略。