细菌、胎盘炎症和新生儿败血症风险的分子检测。
Molecular detection of bacteria, placental inflammation, and neonatal sepsis risk.
机构信息
Department of Pediatrics, Division of Neonatology, NorthShore University HealthSystem, Evanston, IL, USA.
Department of Pediatrics, University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
出版信息
J Perinatol. 2024 Jan;44(1):46-54. doi: 10.1038/s41372-023-01775-5. Epub 2023 Sep 12.
OBJECTIVE
To identify bacteria in umbilical cord tissue and investigate the association with placental inflammation and neonatal sepsis risk score.
STUDY DESIGN
Retrospective cohort study from 2017-2019. RNA was extracted from umbilical cord tissue and NanoString nCounter used to identify seven bacteria genera. Sepsis risk score was calculated using the Kaiser sepsis calculator. Placental histopathology was abstracted from medical records.
RESULTS
Detection of bacterial RNA in the umbilical cord (n = 96/287) was associated with high-stage maternal and fetal acute placental inflammation (maternal 35.4% vs 22.5%, p = 0.03 and fetal 34.4% vs 19.4%, p < 0.01) and maternal vascular malperfusion (36.5% vs 23.0%, p = 0.02). Detection of Ureaplasma spp. was also associated with increased sepsis risk score (1.5/1000 [0.6, 8.6] vs 0.9/1000 [0.2, 2.9], p = 0.04).
CONCLUSION
Umbilical cord bacterial pathogens are linked to fetal and maternal placental inflammation and maternal vascular malperfusion during gestation and associated with increased sepsis risk score in the neonate.
目的
鉴定脐带组织中的细菌，并研究其与胎盘炎症和新生儿败血症风险评分的关系。
研究设计
这是一项 2017-2019 年的回顾性队列研究。从脐带组织中提取 RNA，并用 NanoString nCounter 鉴定七种细菌属。使用 Kaiser 败血症计算器计算败血症风险评分。从病历中提取胎盘组织病理学资料。
结果
在 287 例中，有 96 例（33.5%）检测到脐带细菌 RNA，这与晚期母体和胎儿急性胎盘炎症（母体 35.4% vs 22.5%，p=0.03；胎儿 34.4% vs 19.4%，p<0.01）和母体血管灌注不良（36.5% vs 23.0%，p=0.02）有关。解脲脲原体属的检测也与败血症风险评分增加有关（1.5/1000[0.6, 8.6] vs 0.9/1000[0.2, 2.9]，p=0.04）。
结论
脐带细菌病原体与妊娠期间胎儿和母体胎盘炎症以及母体血管灌注不良有关，并与新生儿败血症风险评分增加有关。
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