Pathological staging of chorioamnionitis comtributes to complications in preterm infants

Abstract

【Abstact】 Objective: To investigate the effect of pathological staging of chorioamnionitis (CA) on complications in preterm infants; Methods: A single-center, retrospective study was conducted to choose singleton preterm infants in our hospital from December 2016 to December 2017. The basic data and placental pathological results were retrospectively collected. The patients were divided into 4 groups according to the placental pathological results, the incidence of common complications in preterm infants in each group was compared, and analyzed the influence of pathological staging of CA on the complications. Further, CA 0/I phase was combined into non-amnitis group, CA II/III phase was combined into amnitis group, gestational age and birth weight were corrected, logistic regression was used to analyze the effects on complications whether inflammation infiltrated amnion according to odds ratio (OR) value. Results: A total of 221 preterm infants were enrolled, including 84 cases of non-chorioamnionitis(CA0), 102 cases of CAI, 30 cases of CAII, and 5 cases of CAIII. The gestational age of CA II and III groups was lower than CA 0 and I, birth weight was lower than that of CA 0 and I, and the hospital stay in CA II and III was longer (P<0.05); The incidence of intraventricular hemorrhage（IVH） in CAII/III group (26.7%, 60.0%) was higher than that in CA 0 and I (15.5%, 9.8%)(P = 0.007),and the early-onset IVH was more common(P=0.021). CA 0, I was divided into non-amnitis group according to whether the inflammation infiltrated the amniotic layer ( placental fetal surface), CA II and III were divided into amnitis group, and the risk of IVH increased by amnitis(OR= 3.248, P value <0.05), and after correction of gestational age and birth weight, the risk of it still increased (OR = 3.236, P value <0.05), the difference was statistically significant. Conclusion: Intrauterine inflammation leads to a significant reduction in gestational age and birth weight in preterm infants ,and it is also an independent risk factor for increasing the incidence of IVH;