Association of different stages of histological chorioamnionitis with respiratory distress syndrome in preterm infants with a gestational age of < 32 weeks
DING Ran, CHEN Qiang, ZHANG Qian-Wei, SUN Qi-Bin, WANG Dai-Jing, SHAN Ruo-Bing
Qingdao Women and Children's Hospital, Qingdao University, Qingdao, Shangdong 266000, China
Abstract Objective To study the association of different stages of histological chorioamnionitis (HCA) with the incidence rate and severity of respiratory distress syndrome (RDS) in preterm infants. Methods Related data were collected from the infants and their mothers who were treated in the Neonatal Intensive Care Unit of Qingdao Women and Children's Hospital, Qingdao University, from January 2018 to June 2020. According to the presence or absence of HCA and its stage, the infants were divided into four groups: control (n=109), early-stage HCA (n=126), middle-stage HCA (n=105), and late-stage HCA (n=36). The four groups were compared in terms of gestational age, birth weight, sex, maternal age, placental abruption, prenatal use of antibiotics, and incidence rate of RDS. The correlation between HCA stage and RDS severity was analyzed. Results Compared with the control and late-stage HCA groups, the early-stage HCA group had a significantly lower incidence rate of placental abruption and a significantly higher rate of prenatal use of antibiotics (P < 0.05), and the early-stage HCA group had a significantly lower incidence rate of RDS than the control group (P < 0.05). The multivariate logistic regression analysis showed that early-, middle-, and late-stage HCA were protective factors against RDS (P < 0.05). The Spearman test showed that the severity of RDS in preterm infants was not correlated with the HCA stage (P > 0.05). Conclusions Early-, middle-, and late-stage HCA can reduce the incidence rate of RDS in preterm infants. HCA stage may not be correlated with RDS severity in preterm infants, which needs to be verified by further research.
DING Ran,CHEN Qiang,ZHANG Qian-Wei et al. Association of different stages of histological chorioamnionitis with respiratory distress syndrome in preterm infants with a gestational age of < 32 weeks[J]. CJCP, 2021, 23(3): 248-253.
DING Ran,CHEN Qiang,ZHANG Qian-Wei et al. Association of different stages of histological chorioamnionitis with respiratory distress syndrome in preterm infants with a gestational age of < 32 weeks[J]. CJCP, 2021, 23(3): 248-253.
Been JV, Vanterpool SF, de Rooij JD, et al. A clinical prediction rule for histological chorioamnionitis in preterm newborns[J]. PLoS One, 2012, 7(10):e46217.
Jobe AH. Effects of chorioamnionitis on the fetal lung[J]. Clin Perinatol, 2012, 39(3):441-457.
[6]
Park CW, Park JS, Jun JK, et al. Mild to moderate, but not minimal or severe, acute histologic chorioamnionitis or intra-amniotic inflammation is associated with a decrease in respiratory distress syndrome of preterm newborns without fetal growth restriction[J]. Neonatology, 2015, 108(2):115-123.
Seehase M, Collins JJ, Kuypers E, et al. New surfactant with SP-B and C analogs gives survival benefit after inactivation in preterm lambs[J]. PLoS One, 2012, 7(10):e47631.
[10]
Khong TY, Mooney EE, Ariel I, et al. Sampling and definitions of placental lesions:Amsterdam Placental Workshop Group consensus statement[J]. Arch Pathol Lab Med, 2016, 140(7):698-713.
[11]
Crum CP, Lee KR. 妇产科诊断病理学[M]. 回允中, 译. 北京:北京大学医学出版社, 2007:1086-1087.
Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-2013 update[J]. Neonatology, 2013, 103(4):353-368.
Watterberg KL, Demers LM, Scott SM, et al. Chorioamnionitis and early lung inflammation in infants in whom bronchopulmonary dysplasia develops[J]. Pediatrics, 1996, 97(2):210-215.
[17]
Miyazaki K, Furuhashi M, Ishikawa K, et al. Impact of chorioamnionitis on short- and long-term outcomes in very low birth weight preterm infants:the Neonatal Research Network Japan[J]. J Matern Fetal Neonatal Med, 2016, 29(2):331-337.
[18]
Lee SM, Kim BJ, Park JS, et al. Risk of intra-amniotic infection/inflammation and respiratory distress syndrome according to the birth order in twin preterm neonates[J]. J Matern Fetal Neonatal Med, 2020, 33(9):1566-1571.
[19]
Ryan E, Eves D, Menon PJ, et al. Histological chorioamnionitis is predicted by early infant C-reactive protein in preterm infants and correlates with neonatal outcomes[J]. Acta Paediatr, 2020, 109(4):720-727.
[20]
Verlato G, Simonato M, Giambelluca S, et al. Surfactant components and tracheal aspirate inflammatory markers in preterm infants with respiratory distress syndrome[J]. J Pediatr, 2018, 203:442-446.
[21]
Wert SE, Whitsett JA, Nogee LM. Genetic disorders of surfactant dysfunction[J]. Pediatr Dev Pathol, 2009, 12(4):253-274.
[22]
Gisslen T, Alvarez M, Wells C, et al. Fetal inflammation associated with minimal acute morbidity in moderate/late preterm infants[J]. Arch Dis Child Fetal Neonatal Ed, 2016, 101(6):F513-F519.
[23]
Lee Y, Kim HJ, Choi SJ, et al. Is there a stepwise increase in neonatal morbidities according to histological stage (or grade) of acute chorioamnionitis and funisitis?:effect of gestational age at delivery[J]. J Perinat Med, 2015, 43(2):259-267.
[24]
Sarno L, Della Corte L, Saccone G, et al. Histological chorioamnionitis and risk of pulmonary complications in preterm births:a systematic review and Meta-analysis[J]. J Matern Fetal Neonatal Med, 2019:1-10.
[25]
Sato M, Nishimaki S, Yokota S, et al. Severity of chorioamnionitis and neonatal outcome[J]. J Obstet Gynaecol Res, 2011, 37(10):1313-1319.
