The Influence of Pregnancy Disorders Causing Preterm Delivery on In-Hospital Outcomes in Preterm Infants at Less than 32 Weeks of Gestation

Abstract

Objective:We assessed the influence of small for gestational age (GA) with placental disorders (SGAP) and histologic chorioamnionitis (HCA) on the inhospital outcomes of preterm infants. Methods: Preterm infants with a GA <32 weeks born at Seoul National University Hospital between 2007 and 2014 were included and divided into 4 groups according to the presence of SGAP and HCA: group 1, SGAP only; group 2, HCA only; group 3, both SGAP and HCA; and group 4, no SGAP or HCA. Multivariate logistic regression was done to compare neonatal outcomes including death, moderate to severe bronchopulmonary dysplasia (BPD) or death, patent ductus arteriosus with treat ment, sepsis, necrotizing enterocolitis ≥stage 2b, and intraventricular hemorrhage ≥grade 3. Results: A total of 572 infants were included. There were 77 patients (13.5%) in group 1, 226 patients (39.5%) in group 2, and 24 patients (4.2%) in group 3. After adjusting for GA, cesarean section, 5 minute Apgar score, multiple pregnancy, premature rupture of membrane before 18 hours prior to delivery, and preeclampsia, group 1 showed higher risks of mortality (adjusted odds ratio [aOR] 3.15, 95% confidence interval [CI] 1.138.80), moderate to severe BPD or death (aOR 9.12, 95% CI 3.98 20.90), sepsis (aOR 2.12, CI 1.014.46), and pulmonary hypertension (aOR 3.26, 95% CI 1.159.22) compared with group 4. There were no significant differences in mortality and inhospital outcomes between groups 2 and 4 or between groups 3 and 4. Conclusion: Close monitoring and early intervention are suggested in SGAP infants.