Ushida Takafumi, Nosaka Rena, Nakatochi Masahiro, Kobayashi Yumiko, Tano Sho, Fuma Kazuya, Matsuo Seiko, Imai Kenji, Sato Yoshiaki, Hayakawa Masahiro, Kajiyama Hiroaki, Kotani Tomomi
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Division of Reproduction and Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
Arch Gynecol Obstet. 2025 May;311(5):1321-1330. doi: 10.1007/s00404-024-07757-y. Epub 2024 Oct 1.
There is growing evidence that preterm infants born to mothers with chorioamnionitis (CAM) have increased risk of various neonatal morbidities and long-term neurological disorders; however, the effect of CAM on postnatal growth remains insufficiently investigated. This study evaluated the effect of histological CAM on postnatal growth trajectories in very preterm infants using a nationwide neonatal database in Japan.
A multicenter retrospective study was conducted using clinical data of 4220 preterm neonates who weighed ≤ 1500 g and were born at < 32 weeks of gestation between 2003-2017 (CAM group: n = 2110; non-CAM group: n = 2110). Z-scores for height and weight were evaluated at birth and 3 years of age. Univariable and multivariable analyses were conducted to evaluate the effect of histological CAM on ΔZ-scores of height and weight during the first three years with a stratification by infant sex and the stage of histological CAM.
Multivariable analyses showed that histological CAM was associated with accelerated postnatal increase (ΔZ-score) in weight (β coefficient [95% confidence interval]; 0.10 [0.00 to 0.20]), but not in height among females (0.06 [- 0.04 to 0.15]) and not in height and weight among males (0.04 [- 0.04 to 0.12] and 0.02 [- 0.07 to 0.11], respectively). An interaction analysis demonstrated no significant difference in the effect of histological CAM on the ΔZ-scores of height and weight during the first three years between male and female infants (height, p = 0.81; weight p = 0.25).
Intrauterine exposure to maternal CAM contributes to accelerated postnatal weight gain in female preterm infants during the first three years.
越来越多的证据表明，患有绒毛膜羊膜炎（CAM）的母亲所生的早产儿出现各种新生儿疾病和长期神经障碍的风险增加；然而，CAM对出生后生长的影响仍未得到充分研究。本研究利用日本全国性的新生儿数据库评估了组织学绒毛膜羊膜炎对极早产儿出生后生长轨迹的影响。
进行了一项多中心回顾性研究，使用了2003年至2017年间体重≤1500克且在妊娠<32周时出生的4220例早产新生儿的临床数据（CAM组：n = 2110；非CAM组：n = 2110）。在出生时和3岁时评估身高和体重的Z评分。进行单变量和多变量分析，以评估组织学绒毛膜羊膜炎对前三年身高和体重ΔZ评分的影响，并按婴儿性别和组织学绒毛膜羊膜炎阶段进行分层。
多变量分析显示，组织学绒毛膜羊膜炎与出生后体重加速增加（ΔZ评分）相关（β系数[95%置信区间]；0.10[0.00至0.20]），但在女性中与身高无关（0.06[-0.04至0.15]），在男性中与身高和体重均无关（分别为0.04[-0.04至0.12]和0.02[-0.07至0.11]）。交互分析表明，在出生后的前三年中，组织学绒毛膜羊膜炎对男婴和女婴身高和体重ΔZ评分的影响没有显著差异（身高，p = 0.81；体重，p = 0.25）。
子宫内暴露于母体绒毛膜羊膜炎有助于女性早产儿在出生后的前三年中体重加速增加。
