Matulova Jana, Kacerovsky Marian, Hornychova Helena, Stranik Jaroslav, Mls Jan, Spacek Richard, Burckova Hana, Jacobsson Bo, Musilova Ivana
Department of Non-Medical Studies, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czechia.
Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czechia.
Front Pharmacol. 2022 Mar 4;13:861785. doi: 10.3389/fphar.2022.861785. eCollection 2022.
To assess the association between the birth weight of newborns from pregnancies with preterm prelabor rupture of membranes (PPROM) and the presence of acute histological chorioamnionitis (HCA) with respect to the: i) fetal and maternal inflammatory responses and ii) acute inflammation of the amnion. This retrospective cohort study included 818 women with PPROM. A histopathological examination of the placenta was performed. Fetal inflammatory response was defined as the presence of any neutrophils in umbilical cord (histological grades 1-4) and/or chorionic vasculitis (histological grade 4 for the chorionic plate). Maternal inflammatory response was defined as the presence of histological grade 3-4 for the chorion-decidua and/or grade 3 for the chorionic plate and/or grade 1-4 for the amnion. Acute inflammation of the amnion was defined as the presence of any neutrophils in the amnion (histological grade 1-4 for the amnion). Birth weights of newborns were expressed as percentiles derived from INTERGROWTH-21st standards for the i) estimated fetal weight and ii) newborn birth weight. No difference in percentiles of birth weights of newborns was found among the women with the women with HCA with fetal inflammatory response, with HCA with maternal inflammatory response and those without HCA. Women with HCA with acute inflammation of the amnion had lower percentiles of birth weights of newborns, derived from the estimated fetal weight standards, than women with HCA without acute inflammation of the amnion and those with the absence of HCA in the crude (with acute inflammation: median 46, without acute inflammation: median 52, the absence of HCA: median 55; = 0.004) and adjusted ( = 0.02) analyses. The same subset of pregnancies exhibited the highest rate of newborns with a birth weight of ≤25 percentile. When percentiles were derived from the newborn weight standards, no differences in birth weights were observed among the subgroups. Acute inflammation of the amnion was associated with a lower birth weight in PPROM pregnancies, expressed as percentiles derived from the estimated fetal weight standards.
为评估胎膜早破（PPROM）妊娠新生儿出生体重与急性组织学绒毛膜羊膜炎（HCA）之间的关联，具体涉及：i）胎儿和母体炎症反应；ii）羊膜急性炎症。这项回顾性队列研究纳入了818例PPROM孕妇。对胎盘进行了组织病理学检查。胎儿炎症反应定义为脐带中存在任何中性粒细胞（组织学分级1 - 4级）和/或绒毛膜血管炎（绒毛膜板组织学分级4级）。母体炎症反应定义为绒毛膜 - 蜕膜组织学分级3 - 4级和/或绒毛膜板分级3级和/或羊膜分级1 - 4级。羊膜急性炎症定义为羊膜中存在任何中性粒细胞（羊膜组织学分级1 - 4级）。新生儿出生体重以基于INTERGROWTH - 21st标准得出的百分位数表示，分别用于：i）估计胎儿体重；ii）新生儿出生体重。在伴有胎儿炎症反应的HCA孕妇、伴有母体炎症反应的HCA孕妇和无HCA孕妇中，未发现新生儿出生体重百分位数存在差异。伴有羊膜急性炎症的HCA孕妇，根据估计胎儿体重标准得出的新生儿出生体重百分位数低于无羊膜急性炎症的HCA孕妇和无HCA孕妇，在粗分析（有急性炎症：中位数46，无急性炎症：中位数52，无HCA：中位数55；P = 0.004）和校正分析（P = 0.02）中均如此。同一组妊娠中，出生体重≤第25百分位数的新生儿比例最高。当根据新生儿体重标准得出百分位数时，各亚组间未观察到出生体重差异。在PPROM妊娠中，羊膜急性炎症与较低的出生体重相关，以基于估计胎儿体重标准得出的百分位数表示。
