1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital Alexandra, 11528 Athens, Greece.
Department of Internal Medicine, Koutlimbaneio and Triantafylleio General Hospital of Larissa, 41221 Larissa, Greece.
Cells. 2023 Jan 4;12(2):209. doi: 10.3390/cells12020209.
It is estimated that inflammation at the placental-maternal interface is directly responsible for or contributes to the development of 50% of all premature deliveries. Chorioamnionitis, also known as the premature rupture of the amniotic membrane in the mother, is the root cause of persistent inflammation that preterm newborns experience. Beyond contributing to the onset of early labor, inflammation is a critical element in advancing several conditions in neonates, including necrotizing enterocolitis, retinopathy of prematurity, bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity and periventricular leukomalacia. Notably, the immune systems of preterm infants are not fully developed; immune defense mechanisms and immunosuppression (tolerance) have a delicate balance that is easily upset in this patient category. As a result, premature infants are exposed to different antigens from elements such as hospital-specific microbes, artificial devices, medications, food antigens and hypoxia/hyperoxia. This has detrimental implications for preterm deliveries of less than 28 weeks because they have not yet evolved the mechanisms to tolerate maternal and self-antigens.
据估计,胎盘-母体界面的炎症直接导致或促成了所有早产儿中 50%的早产儿的发生。绒毛膜羊膜炎,也称为母亲的羊膜过早破裂,是早产儿持续炎症的根本原因。炎症不仅导致早产,还是许多新生儿疾病的关键因素,包括坏死性小肠结肠炎、早产儿视网膜病变、支气管肺发育不良、脑室出血、早产儿视网膜病变和脑室周围白质软化。值得注意的是,早产儿的免疫系统尚未完全发育;免疫防御机制和免疫抑制(耐受)之间存在微妙的平衡,在这一患者群体中很容易被打破。因此,早产儿会接触到来自医院特有微生物、人工设备、药物、食物抗原和缺氧/高氧等不同的抗原。这对不足 28 周的早产儿分娩产生不利影响,因为他们尚未发展出耐受母体和自身抗原的机制。