Placenta, secret witness of infant morbidities: the relationship between placental histology and outcome of the premature infant

Çakır, Ufuk; Yildiz, Duran; Kahvecioglu, Dilek; Okulu, Emel; Alan, Serdar; Erdeve, Ömer; Heper, Aylın Okçu; Atasay, Begüm; Arsan, Saadet

doi:10.5146/tjpath.2018.01443

Cited by 9 publications

(8 citation statements)

References 36 publications

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“…We also included 11 additional studies. 61,66,68,73,75,76,82,85,[102][103][104] The strengths of our study include delineation of histologic chorioamnionitis from clinical chorioamnionitis and early-onset neonatal sepsis from lateonset neonatal sepsis to provide more specific, focused results. Further, we performed subanalyses to parse out effects of confirmed only compared with presumed neonatal sepsis, and effects for preterm only compared with combined preterm and term neonate populations.…”

Section: Discussionmentioning

confidence: 99%

Chorioamnionitis and Risk for Maternal and Neonatal Sepsis

Beck¹,

Gallagher²,

Taylor³

et al. 2021

Obstetrics &Amp; Gynecology

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OBJECTIVE: To estimate the risk of maternal and neonatal sepsis associated with chorioamnionitis. DATA SOURCES: PubMed, BIOSIS, and ClinicalTrials.gov databases were systematically searched for full-text articles in English from inception until May 11, 2020. METHODS OF STUDY SELECTION: We screened 1,251 studies. Randomized controlled trials, case-control, or cohort studies quantifying a relationship between chorioamnionitis and sepsis in mothers (postpartum) or neonates born at greater than 22 weeks of gestation were eligible. Studies were grouped for meta-analyses according to exposures of histologic or clinical chorioamnionitis and outcomes of maternal or neonatal sepsis. TABULATION, INTEGRATION, AND RESULTS: One hundred three studies were included, and 55 met criteria for meta-analysis (39 studies of preterm neonates, 10 studies of general populations of preterm and term neonates, and six studies of late preterm and term neonates). Study details and quantitative data were abstracted. Random-effects models were used to generate pooled odds ratios (ORs); most studies only reported unadjusted results. Histologic chorioamnionitis was associated with confirmed and any early-onset neonatal sepsis (unadjusted pooled ORs 4.42 [95% CI 2.68–7.29] and 5.88 [95% CI 3.68–9.41], respectively). Clinical chorioamnionitis was also associated with confirmed and any early-onset neonatal sepsis (unadjusted pooled ORs 6.82 [95% CI 4.93–9.45] and 3.90 [95% CI 2.74–5.55], respectively). Additionally, histologic and clinical chorioamnionitis were each associated with higher odds of late-onset sepsis in preterm neonates. Confirmed sepsis incidence was 7% (early-onset) and 22% (late-onset) for histologic and 6% (early-onset) and 26% (late-onset) for clinical chorioamnionitis-exposed neonates. Three studies evaluated chorioamnionitis and maternal sepsis and were inconclusive. CONCLUSION: Both histologic and clinical chorioamnionitis were associated with early- and late-onset sepsis in neonates. Overall, our findings support current guidelines for preventative neonatal care. There was insufficient evidence to determine the association between chorioamnionitis and maternal sepsis. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42020156812.

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Section: Discussionmentioning

confidence: 99%

Chorioamnionitis and Risk for Maternal and Neonatal Sepsis

Beck¹,

Gallagher²,

Taylor³

et al. 2021

Obstetrics &Amp; Gynecology

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“…Additionally, in pregnant women carrying GBS, the bacteria can spread from the vagina to the placenta, resulting in chorioamnionitis before delivery 29. As a consequence, infants born to mothers with chorioamnionitis are often born preterm, leading to a higher incidence of LBW 30…”

Section: Discussionmentioning

confidence: 99%

Colonisation of Group BStreptococcusand its effects on pregnancy outcomes in pregnant women in Guangzhou, China: a retrospective study

Liu,

Zhuang

et al. 2023

BMJ Open

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ObjectivesThis study was to investigate the colonisation rate of Group BStreptococcus(GBS) during pregnancy, and to evaluate the influence of GBS colonisation on pregnancy outcomes.DesignA retrospective cohort study.SettingData of 47 380 pregnant women from 2016 to 2022 were collected from the Maternal and Child Health Hospital of Huadu District, Guangzhou City, China.ParticipantsA total of 15 040 pregnant women were eligible for this study, of which 32 340 were excluded due to non-native pregnant women, in vitro fertilization infants, malformed fetuses, habitual abortion, abortions due to poor reproductive or obstetrical history, artificial insemination, umbilical cord torsion, and other diseases during pregnancy.Primary outcome measuresThe incidence rates of GBS colonisation and premature delivery, fetal distress, premature rupture of membranes (PROM), low birth weight (LBW), abortion and stillbirth.ResultsOf the 15 040 pregnant women included in this study, 1445 developed GBS colonisation, with a prevalence of 9.61% (95% CI, 9.15 to 10.09). Advanced maternal age (≥35 years) predisposed women to GBS colonisation, and the occurrence of GBS colonisation varied among different ethnic groups. Our data revealed that fetal distress, PROM and LBW were more common in pregnant women colonised with GBS than in pregnant women not colonised with GBS. The incidence for premature delivery, fetal distress, PROM and LBW in infants of pregnant women colonised with GBS was 41.0% (OR=1.410, 95% CI, 1.134 to 1.753), 282.5% (OR=3.825, 95% CI, 3.185 to 4.593), 14.9% (OR=1.149, 95% CI, 1.005 to 1.313), and 29.7% (OR=1.297, 95% CI, 1.010 to 1.664), respectively.ConclusionsGBS colonisation was relatively low in pregnant women in Guangzhou. Women of advanced maternal age were more prone to GBS colonisation, and pregnant women colonised with GBS were more predisposed to fetal distress, PROM and LBW.

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“…Crude and adjusted odds ratios (OR) were calculated with a 95% confidence interval. Confounders were included according to clinical relevancy; so, the maximal model comprises gender [41], gestational age [42], antenatal steroids [43], and placental histology [44]. CRIB scores were not included as they could be affected by the different respiratory management strategies employed and also to avoid collinearity with gestational age.…”

Section: Discussionmentioning

confidence: 99%

Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates

et al. 2020

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The development of devices that can fix the tidal volume in high-frequency oscillatory ventilation (HFOV) has allowed for a significant improvement in the management of HFOV. At our institution, this had led to the earlier use of HFOV and promoted a change in the treatment strategy involving the use of higher frequencies (above 15 Hz) and lower high-frequency tidal volumes (VThf). The purpose of this observational study was to assess how survival without bronchopulmonary dysplasia grades 2 and 3 (SF-BPD) is influenced by these modifications in the respiratory strategy applied to preterm infants (gestational age < 32 weeks at birth) who required mechanical ventilation (MV) in the first 3 days of life. We compared a baseline period (2012-2013) against a period in which this strategy had been fully implemented (2016-2017). A total of 182 patients were exposed to MV in the first 3 days of life being a higher proportion on HFOV at day 3 in the second period 79.5% (n 35) in 2016-2017 vs 55.4% (n 31) in 2012-2013. After adjusting for perinatal risk factors, the second period is associated with an increased rate of SF-BPD (OR 2.28; CI 95% 1.072-4.878); this effect is more evident in neonates born at a gestational age of less than 29 weeks (OR 4.87; 95% CI 1.9-12.48). Conclusions : The early use of HFOV combined with the use of higher frequencies and very low VT was associated with an increase in the study population's SF-BPD. What is Known: • High-frequency ventilation with volume guarantee improve ventilation stability and has been shown to reduce lung damage in animal models. What is New: • The strategy of an earlier use of high-frequency oscillatory ventilation combined with the use of higher frequencies and lower tidal volume is associated to an increase in survival without bronchopulmonary dysplasia in our population of preterm infants. Keywords High-frequencyventilation. Lung protection. Bronchopulmonary dysplasia. Ventilatory-induced lung injury. Target tidal volume. Preterm infants Abbreviations ΔPhf Delta pressure BPD Bronchopulmonary dysplasia type 2-3 BW Birth weight CMV Conventional mechanical ventilation CRIB Critical index for babies DOL Days of life GA Gestational age HFOV High-frequency oscillatory ventilation Hz Hertz INSURE Intubation-surfactant administration-extubation LISA Less-invasive surfactant administration MV Mechanical ventilation nCPAP Nasal continuous airway pressure NEC Necrotizing enterocolitis Communicated by Daniele De Luca

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Placenta, secret witness of infant morbidities: the relationship between placental histology and outcome of the premature infant

Cited by 9 publications

References 36 publications

Chorioamnionitis and Risk for Maternal and Neonatal Sepsis

Chorioamnionitis and Risk for Maternal and Neonatal Sepsis

Colonisation of Group BStreptococcusand its effects on pregnancy outcomes in pregnant women in Guangzhou, China: a retrospective study

Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates

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