Pathological staging of chorioamnionitis contributes to complications in preterm infants

Abstract

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 (gestational age < 37 weeks) from the Department of Obstetrics and Gynecology in our hospital from December 2016 to December 2017. The basic data and placental pathological results were retrospectively collected. According to the placental pathological results of whether inflammation infiltrating amnion, CA 0/I phase was classified into non-amnionitis group, CA II/III phase was classified into amnionitis group, the incidence of common complications in preterm infants was compared. Further, logistic regression was used to analyze the effects of amnionitis on complications after being adjusted to gestational age, birth weight and thrombocytopenia. Results A total of 221 preterm infants were enrolled, including 186 cases in non-amnionitis group and 35 cases in amnionitis group. The gestational age of amnionitis group (32.00 ± 2.71 weeks) was significantly lower than non-amnionitis group (34.14 ± 2.06 weeks), birth weight (1.93 ± 0.64 kg) was significantly lower than that of non-amnionitis group (2.26 ± 0.58 kg), and the hospital stay in amnionitis group was significantly longer (25.71 ± 19.23 days), all of the difference above was statistically significant(P < 0.05). The incidence of intraventricular hemorrhage (IVH) in amnionitis group (37.14%) was significantly higher than that in non-amnionitis group (13.98%) (P = 0.002), and the risk of IVH was significantly increased by amnionitis (OR = 3.636, 95%CI: 1.632–8.102); after correction of gestational age, birth weight and thrombocytopenia, the risk of IVH was still significantly increased (OR = 2.471, P = 0.046, 95% CI: 1.015–6.015). And the late-onset IVH was more common (P = 0.009). Conclusion Amnionitis leads to a significant reduction in gestational age and birth weight in preterm infants, and it is an independent risk factor for IVH.

Predictive Risk Factors for Mild and Severe Germinal Matrix Hemorrhage and Associated Neurodevelopmental Prognosis: A Retrospective Study

“…Gestational Age (Mean ± SD) 28.09 ± 3.397 27.47 ± 3.893 0.55 Our study showed that mothers who had amnionitis were more likely to have a neonate with severe GMH-IVH. In consistent with our findings, previous studies showed that amnionitis could cause low GA and birth weight which they considered them as risk factors for severe GMH-IVH [8,9].…”

Risk factors and postnatal biomarkers for acute placental inflammatory lesions and intrauterine infections in preterm infants

“…Moreover, Apgar score, endotracheal intubation rate, mechanical ventilation rate, pulmonary surfactant application, severe PDA rate and the incidence of BPD in very low birth weight infants were related to HCA [18]. Maternal amnionitis led to the low gestational age and low birth weight of preterm infants, and it was an independent risk factor for intraventricular hemorrhage [19]. Therefore, it is extraordinarily urgent to discover possible risk factors and predictive biomarkers of intrauterine infection in the early stage to reduce the complications of preterm infants by intervening timely.…”

The Fetal Inflammatory Response Syndrome (Clinical lecture)

“…Внутрішньоутробна інфекція/запалення є причетним до розвитку ПВЛ, що надалі призводить до рухових і когнітивних порушень у немовляти, ДЦП, розладів аутичного спектра (РАС) та ін. [19].…”

“…• 1-а стадія -амніотропна міграція фетальних нейтрофільних гранулоцитів у стінку м'язового шару пуповинної вени (флебіт); • 2-а стадія -артеріїт; • 3-я стадія -некротичний фунікуліт з інфільтрацією желе Уортона (концентричне периваскулярне поширення дегенерованих нейтрофільних гранулоцитів) [19]. Виявлення тромбів також розглядають як серйозне запалення плода.…”

“…При зриві імунологічної толерантності материнські лімфоцити проникають в тканину плода (хоріальні мембрани при хронічному хоріоамніоніті, ворсинчасте дерево при ВНЕ і базальну пластинку плаценти при хронічному децидуїті), виникає відторгнення трансплантата, його функціональна недостатність, яка під час вагітності стає патогенетичним механізмом формування великих акушерських синдромів, а також патології плода. Спостерігається підвищена частота даної патології при повністю алогенних вагітностяхвикористання донорських яйцеклітин [19].…”