Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.
Department of Pathology, China-Japan Friendship Hospital, Beijing, China.
Eur J Pediatr. 2022 Sep;181(9):3429-3438. doi: 10.1007/s00431-022-04545-1. Epub 2022 Jul 14.
The purpose of this study is to explore risk factors of acute placental inflammatory lesions and the potential postnatal serum biomarkers for predicting the severity of intrauterine infection in preterm infants. We performed a retrospective analysis of premature infants with or without acute placental inflammatory lesions and their mothers by chart review for clinical data and placental histopathology. The preterm infants with acute placental inflammatory lesions had a higher rate of premature rupture of membranes (PROM), a longer duration of PROM, and a higher level of serum sialic acid (SIA) than those of the non-inflammation group (all p < 0.001). According to the different inflammatory histological structures, preterm infants with funisitis had a dominant longer duration of PROM than others (p < 0.05), and their gestational age was youngest among all the infants (p < 0.05). Furthermore, they had the highest content of serum SIA above other groups. The preterm infants in the acute histological chorioamnionitis group showed a similar trend of clinical manifestation and laboratory parameters with the funisitis group. Moreover, the closer the placental lesions were to the fetus, the lower the gestational age of preterm infants was, and the higher the serum SIA content was.
We utilized a simple and precise anatomically category method of placental inflammatory histopathology for pediatricians to distinguish the extent of fetal inflammatory response for representing early-onset infectious diseases of preterm infants. SIA might be one of the potential early-stage serum biomarkers to reflect the severe intrauterine infections and could guide the postnatal anti-infection treatment.
• Acute placental inflammatory lesion contributes to preterm birth and a series of complications in preterm infants. • C-reactive protein and interleukin-6 in neonatal blood can be used as biomarkers for potential early-onset sepsis, but they are influenced by the postnatal physiological changes of preterm infants.
• The value of serum sialic acids of preterm infants within 1-hour afterbirth may be one of the rapid postnatal biomarkers for evaluating the severity of intra-amniotic infection. • The closer the placental lesions are to the fetus, the higher the content of serum sialic acid is.
本研究旨在探讨急性胎盘炎症病变的危险因素，以及预测早产儿宫内感染严重程度的潜在产后血清生物标志物。
我们通过图表回顾分析了有或无急性胎盘炎症病变的早产儿及其母亲的临床数据和胎盘组织病理学。与非炎症组相比，急性胎盘炎症病变早产儿的胎膜早破（PROM）发生率更高（PROM）、胎膜早破时间更长、血清唾液酸（SIA）水平更高（均 P<0.001）。根据不同的炎症组织学结构，有脐带炎的早产儿的 PROM 时间明显长于其他早产儿（p<0.05），且其胎龄在所有早产儿中最小（p<0.05）。此外，他们的血清 SIA 含量也明显高于其他组。急性组织学绒毛膜羊膜炎组的早产儿表现出与脐带炎组相似的临床表现和实验室参数趋势。此外，胎盘病变越靠近胎儿，早产儿的胎龄越低，血清 SIA 含量越高。
我们利用一种简单而精确的胎盘炎症组织病理学解剖分类方法，使儿科医生能够区分胎儿炎症反应的程度，从而代表早产儿的早发性感染性疾病。SIA 可能是反映严重宫内感染的潜在早期血清生物标志物之一，可以指导产后抗感染治疗。
急性胎盘炎症病变导致早产和早产儿一系列并发症。新生儿血液中的 C 反应蛋白和白细胞介素 6 可作为潜在早发性败血症的生物标志物，但它们受早产儿出生后生理变化的影响。
出生后 1 小时内早产儿血清唾液酸的价值可能是评估羊膜内感染严重程度的快速产后生物标志物之一。胎盘病变越靠近胎儿，血清唾液酸含量越高。
