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绒毛膜血管病对新生儿的影响：450例临床分析
Influence of placental pathological chorangiosis on neonates: an analysis of 450 cases
目的 研究母亲胎盘病理绒毛膜血管病对新生儿病死率和并发症发生率的影响。方法 回顾性分析2016年7月至2020年2月厦门市妇幼保健院新生儿科生后3 d内住院的患儿，根据母亲胎盘病理是否提示绒毛膜血管病分为观察组和对照组，各450例。分析两组患儿的一般情况、母亲妊娠期合并症、新生儿病死率和新生儿并发症的发生率。结果 观察组剖宫产率高于对照组（P < 0.05），观察组母亲妊娠高血压发生率高于对照组（P < 0.05）。与对照组相比，观察组患儿先天结构畸形、小于胎龄儿、低Apgar评分发生率更高（P < 0.05）；观察组患儿病死率、脑损伤发生率、早产儿视网膜病及宫外生长发育迟缓的发生率均更高（P < 0.05）。结论 母亲胎盘病理绒毛膜血管病的新生儿病死率更高，并发症发生率更高，需提高对绒毛膜血管病的认识，尽早干预，减少并发症，改善预后。
Objective To study the influence of placental pathological chorangiosis in the mother on the mortality of neonates and the incidence rate of complications. Methods A retrospective analysis was performed for the neonates who were hospitalized within 3 days after birth in the Department of Neonatology, Xiamen Maternal and Child Health Hospital, from July 2016 to February 2020. According to whether the placental pathology showed chorangiosis, the neonates were divided into an observation group and a control group (n=450 each). The two groups were analyzed in terms of general status, maternal comorbidities during pregnancy, neonatal mortality, and incidence rate of complications in neonates. Results Compared with the control group, the observation group had a significantly higher cesarean section rate (P < 0.05) and a significantly higher incidence rate of maternal gestational hypertension (P < 0.05). The observation group had significantly higher incidence rates of congenital malformation, small-for-gestational-age birth, and low Apgar score than the control group (P < 0.05). The observation group also had significantly higher mortality rate and incidence rates of brain injury, retinopathy of prematurity, and extrauterine growth retardation (P < 0.05). Conclusions Neonates born to mothers with placental pathological chorangiosis tend to have a higher morbidity rate and incidence rate of complications. It is important to improve the understanding of chorangiosis and provide intervention as soon as possible, in order to reduce complications and improve prognosis.
绒毛膜血管病 / 胎盘病理 / 病死率 / 并发症 / 新生儿
Chorangiosis / Placental pathology / Mortality / Complication / Neonate
[1] Altshuler G. Chorangiosis. An important placental sign of neonatal morbidity and mortality[J]. Arch Pathol Lab Med, 1984, 108(1):71-74.
[2] Vafaei H, Karimi Z, Akbarzadeh-Jahromi M, et al. Association of placental chorangiosis with pregnancy complication and prenatal outcome:a case-control study[J]. BMC Pregnancy Childbirth, 2021, 21(1):99.
[3] Gupta D, Singh P. Chorangiosis of the placenta:association with maternal profile and neonatal outcome, experience at our centre[J]. J Med Sci Clin Res, 2018, 6(2):1184-1187.
[4] 中华医学会围产医学分会新生儿复苏学组. 新生儿窒息诊断的专家共识[J]. 中华围产医学杂志, 2016, 19(1):3-6.
[5] 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 5版. 北京:人民卫生出版社, 2019.
[6] 李欢喜, 吴泉峰, 谢静娴, 等. 280例胎盘绒毛膜血管病的临床特点及胎儿结局分析[J]. 实用妇产科杂志, 2020, 36(6):472-474.
[7] Vik T, Redline R, Nelson KB, et al. The placenta in neonatal encephalopathy:a case-control study[J]. J Pediatr, 2018, 202:77-85.e3.
[8] Petersen SS, Khangura R, Davydov D, et al. Placental chorangiosis:increased risk for cesarean section[J]. Case Rep Obstet Gynecol, 2017, 2017:5610945.
[9] Stanek J. Chorangiosis of chorionic villi:what does it really mean?[J]. Arch Pathol Lab Med, 2016, 140(6):588-593.
[10] Rychik J, Goff D, McKay E, et al. Characterization of the placenta in the newborn with congenital heart disease:distinctions based on type of cardiac malformation[J]. Pediatr Cardiol, 2018, 39(6):1165-1171.
[11] Schwartz DA. Chorangiosis and its precursors:underdiagnosed placental indicators of chronic fetal hypoxia[J]. Obstet Gynecol Surv, 2001, 56(9):523-525.
[12] 洪昆峣, 林新祝. 绒毛膜血管病的研究进展[J]. 发育医学电子杂志, 2020, 8(4):370-372.
[13] Barut A, Barut F, Kandemir NO, et al. Placental chorangiosis:the association with oxidative stress and angiogenesis[J]. Gynecol Obstet Invest, 2012, 73(2):141-151.
[14] Cai CRR, Tahiri H, Fortin C, et al. Lymphocytic microparticles suppress retinal angiogenesis via targeting Müller cells in the ischemic retinopathy mouse model[J]. Exp Cell Res, 2021, 399(2):112470.
[15] Razak A, Faden M. Association of small for gestational age with retinopathy of prematurity:a systematic review and meta-analysis[J]. Arch Dis Child Fetal Neonatal Ed, 2020, 105(3):270-278.
[16] 王爱春, 马亚琪, 王昀, 等. 胎盘绒毛膜血管瘤25例临床病理分析[J]. 中华病理学杂志, 2015, 44(8):600-602.
[17] 尹婵, 童立里, 谭晓群, 等. 胎盘绒毛膜血管病超声表现1例[J]. 临床超声医学杂志, 2018, 20(10):674.
[18] Garg N, Diwaker P, Aggarwal S, et al. Chorangiosis placenta with 5-vessel umbilical cord with omphalomesenteric duct remnant:an unusual association[J]. Turk J Obstet Gynecol, 2018, 15(4):270-272.
2017年厦门市科技重大专项（3502Z2017006）。
