Department of Pediatrics, Xindu District People's Hospital, Chengdu, Sichuan Province, China.
Department of Pediatrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan Province, China.
J Int Med Res. 2024 Nov;52(11):3000605241286728. doi: 10.1177/03000605241286728.
To identify the risk factors for and short-term prognosis of intrauterine infection (IUI) in preterm infants.
We retrospectively collected clinical data regarding preterm infants (28-36 weeks of gestational age) with IUI from the neonatal intensive care unit of our hospital between June 2017 and June 2022. The pathologic characteristics of the infants were classified using the Redline criteria, and the resulting groups were compared with respect to their clinical characteristics, indicators of infection, complications, and mortality rates.
Three hundred thirty (78.1%) of the 422 enrolled neonates showed signs of histologic IUI; 51.8% showed histologic chorioamnionitis alone, and 48.2% showed both histologic chorioamnionitis and funisitis. The independent risk factors identified for IUI were maternal prenatal invasive manipulation, premature rupture of membranes (>18 hours before labor), and prenatal C-reactive protein concentration. The infants with IUI showed higher incidences of respiratory distress syndrome, bronchopulmonary dysplasia, retinopathy of prematurity, and prolonged mechanical ventilation. Low gestational age and low birth weight of preterm infants were significantly associated with a higher incidence of histologic IUI, more severe inflammation, and a higher incidence of complications.
Histologic IUI is associated with high complication and mortality rates in preterm infants, as is an increasing severity of inflammation.
确定早产儿宫内感染（IUI）的危险因素和短期预后。
我们回顾性地收集了 2017 年 6 月至 2022 年 6 月期间我院新生儿重症监护病房中患有 IUI 的早产儿（28-36 周胎龄）的临床数据。根据 Redline 标准对婴儿的病理特征进行分类，并对各组的临床特征、感染指标、并发症和死亡率进行比较。
330 名（78.1%）422 名入组新生儿出现组织学 IUI 征象；单纯组织学绒毛膜羊膜炎占 51.8%，同时合并组织学绒毛膜羊膜炎和脐带炎占 48.2%。IUI 的独立危险因素为母亲产前有侵入性操作、胎膜早破（分娩前>18 小时）和产前 C 反应蛋白浓度。患有 IUI 的婴儿呼吸窘迫综合征、支气管肺发育不良、早产儿视网膜病变和机械通气时间延长的发生率更高。低胎龄和低出生体重与组织学 IUI 发生率更高、炎症更严重以及并发症发生率更高显著相关。
组织学 IUI 与早产儿的高并发症和死亡率相关，炎症程度也越来越严重。
