Sun Tong, Fu Jianhua
Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.
Front Pediatr. 2021 Dec 9;9:774150. doi: 10.3389/fped.2021.774150. eCollection 2021.
To analyze the clinical characteristics of intrauterine (UU) infection in premature infants. In this single-center retrospective case-control study, 291 preterm infants born in our hospital and hospitalized in our department and gestational age no more than 32 weeks, birth weight no more than 2000 g were included from January 2019 to January 2021. Lower respiratory tract secretion, gastric fluid and urine were collected for UU RNA detection within 48 h after birth. Intrauterine UU infection is defined by at least one positive UU-PCR test of secreta or excreta of preterm infants after birth. The UU infection group included 86 preterm infants and the non-UU infection group included 205 preterm infants. We compared their clinical features, hemogram changes and disease outcomes using statistical analyses. The clinical characteristics of premature infants such as the duration of oxygen use and ventilator use in hospital were significantly prolonged in the UU infection group ( < 0.05). The levels of leukocytes, platelet and procalcitonin in the UU infection group were significantly higher than in the non-UU infection group ( < 0.05). In terms of preterm complications, only the incidences of bronchopulmonary dysplasia, retinopathy of prematurity and metabolic bone disease in premature infants in the UU infection group were significantly higher than those in the non-UU infection group ( < 0.05). The mode of delivery, maternal premature rupture of membranes, and postnatal leukocyte level were independent risk factors for UU infection, while gestational hypertension was a protective factor for UU infection. The level of leukocytes in postnatal hemogram of premature infants could be used as a diagnostic index of UU infection, but the diagnostic accuracy was poor. In our study, UU infection can increase the incidence of bronchopulmonary dysplasia, retinopathy of prematurity and metabolic bone disease in preterm infants, but have no effect on the incidence of necrotizing enterocolitis, intracranial hemorrhage, white matter damage and other diseases in preterm infants. For high-risk premature infants, UU should be detected as soon as possible after birth, early intervention and drug treatment necessarily can improve the prognosis as much as possible.
分析早产儿宫内解脲脲原体（UU）感染的临床特征。在这项单中心回顾性病例对照研究中，纳入了2019年1月至2021年1月在我院出生并在我科住院的291例孕周不超过32周、出生体重不超过2000g的早产儿。出生后48小时内采集下呼吸道分泌物、胃液和尿液进行UU RNA检测。宫内UU感染定义为早产儿出生后分泌物或排泄物的UU-PCR检测至少一项为阳性。UU感染组包括86例早产儿，非UU感染组包括205例早产儿。采用统计学分析比较两组的临床特征、血常规变化及疾病转归。UU感染组早产儿的住院用氧时间、呼吸机使用时间等临床特征明显延长（P<0.05）。UU感染组白细胞、血小板及降钙素原水平明显高于非UU感染组（P<0.05）。在早产并发症方面，仅UU感染组早产儿支气管肺发育不良、早产儿视网膜病变及代谢性骨病的发生率明显高于非UU感染组（P<0.05）。分娩方式、母亲胎膜早破及出生后白细胞水平是UU感染的独立危险因素，而妊娠期高血压是UU感染的保护因素。早产儿出生后血常规白细胞水平可作为UU感染的诊断指标，但诊断准确性较差。在本研究中，UU感染可增加早产儿支气管肺发育不良、早产儿视网膜病变及代谢性骨病的发生率，但对早产儿坏死性小肠结肠炎、颅内出血、白质损伤等疾病的发生率无影响。对于高危早产儿，出生后应尽早检测UU，早期干预及药物治疗必能尽可能改善预后。
