胎盘病理表现与早产儿坏死性小肠结肠炎严重程度的相关性：一项匹配病例对照研究。
Association of Placental Pathologic Findings with the Severity of Necrotizing Enterocolitis in Preterm infants - A Matched Case-Control Study.
机构信息
Department of Pediatrics/Neonatology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi, USA.
出版信息
Fetal Pediatr Pathol. 2023 Apr;42(2):187-197. doi: 10.1080/15513815.2022.2110340. Epub 2022 Aug 18.
OBJECTIVE
To determine the association of placental pathology with the severity of necrotizing enterocolitis (NEC) in preterm infants.
METHODS
This single-center matched case-control study included infants with NEC ( = 107) and gestational age and birth weight-matched controls ( = 130), born between 2013 and 2020. Placentas were evaluated according to the Amsterdam Placental Workshop Group Consensus Statement.
RESULTS
Acute histologic chorioamnionitis with the fetal response was significantly more common in infants with surgical NEC vs. medical NEC (35.4% vs. 15.3%; = 0.02). On regression model, infants with multiple placental pathologies (OR 2.16; 95% CI 1.01 - 4.73; = 0.04) and maternal vascular malperfusion (OR 2.2; 95% CI 1.12 - 4.51; = 0.02) had higher odds of either medical or surgical NEC than controls.
CONCLUSION
Infants with multiple placental lesions, including placental inflammatory and vascular lesions, were at higher risk of medical or surgical NEC in the postnatal period.
目的
确定胎盘病理学与早产儿坏死性小肠结肠炎（NEC）严重程度的关系。
方法
本单中心匹配病例对照研究纳入了 2013 年至 2020 年期间出生的 NEC 患儿（n=107）和胎龄及出生体重匹配的对照组患儿（n=130）。根据阿姆斯特丹胎盘研讨会专家组共识声明评估胎盘。
结果
与非手术 NEC 患儿相比，手术 NEC 患儿的急性组织学绒毛膜羊膜炎伴胎儿反应更为常见（35.4% vs. 15.3%；=0.02）。在回归模型中，存在多种胎盘病变（OR 2.16；95% CI 1.01-4.73；=0.04）和母体血管功能不全（OR 2.2；95% CI 1.12-4.51；=0.02）的患儿与对照组相比，更有可能发生非手术或手术 NEC。
结论
存在多种胎盘病变（包括胎盘炎症和血管病变）的患儿在出生后更有可能发生医学或手术 NEC。
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