Gunawan Emily, Jain Viral G, Hardy Shakia, Irvin M Ryan, Salas Ariel A
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Pediatr Res. 2025 Sep 19. doi: 10.1038/s41390-025-04413-2.
In utero insults such as chorioamnionitis are associated with adverse outcomes. This study aims to examine the association between chorioamnionitis and fat mass (FM) in very preterm infants.
We conducted a retrospective cohort study of mother-infant dyads born <32 weeks of gestation. Infant FM accretion was measured using air displacement plethysmography at term-equivalent age. Histological chorioamnionitis severity was staged based on placental pathology and included maternal/chorion-amnion inflammatory response (MIR) and fetal/umbilical cord inflammatory response (FIR). The association between chorioamnionitis severity and FM accretion was analyzed using linear regression models and mediation analyses.
Among 375 mother-infant dyads analyzed, 104 (28%) dyads had MIR. FIR was found in 85 dyads with MIR (82%). Infants without MIR had lower FM in Kg and lower FM z scores than those with MIR (p = 0.0001). Infants with severe MIR had higher body fat percentages (Stage 3: 18% vs Stage 1: 14%, p < 0.0001). There were no significant differences in other anthropometric growth rates. Gestational age partially mediated this association (49%).
Severe histological chorioamnionitis is associated with greater FM accretion at term-equivalent age, independent of gestational age. Without long-term data, it remains unclear whether this early-onset effect is transient or persists into later childhood.
Chorioamnionitis is common in infants born preterm and is strongly associated with preterm birth. Infants born preterm exposed to chorioamnionitis have an increased risk of abnormal fat mass accretion at term equivalent age. Accounting for the severity of chorioamnionitis could improve the interpretation of body fat accretion in infants born preterm.
诸如绒毛膜羊膜炎等宫内损伤与不良结局相关。本研究旨在探讨绒毛膜羊膜炎与极早产儿脂肪量（FM）之间的关联。
我们对孕周小于32周的母婴二元组进行了一项回顾性队列研究。在足月等效年龄时，使用空气置换体积描记法测量婴儿的FM增加量。根据胎盘病理学对组织学绒毛膜羊膜炎的严重程度进行分期，包括母体/绒毛膜 - 羊膜炎症反应（MIR）和胎儿/脐带炎症反应（FIR）。使用线性回归模型和中介分析来分析绒毛膜羊膜炎严重程度与FM增加量之间的关联。
在分析的375对母婴二元组中，104对（28%）有MIR。在85对有MIR的二元组中发现了FIR（82%）。没有MIR的婴儿的千克体重FM和FM z评分低于有MIR 的婴儿（p = 0.0001）。患有严重MIR的婴儿的体脂百分比更高（3期：18% 对1期：14%，p < 0.0001）。其他人体测量生长率没有显著差异。胎龄部分介导了这种关联（49%）。
严重的组织学绒毛膜羊膜炎与足月等效年龄时更大的FM增加量相关，独立于胎龄。由于缺乏长期数据，目前尚不清楚这种早期发作的影响是短暂的还是会持续到儿童后期。
绒毛膜羊膜炎在早产儿中很常见，并且与早产密切相关。暴露于绒毛膜羊膜炎的早产儿在足月等效年龄时脂肪量异常增加的风险增加。考虑绒毛膜羊膜炎的严重程度可以改善对早产儿体脂增加的解释。
