The Association of Histological Chorioamnionitis and Antenatal Steroids on Neonatal Outcome in Preterm Infants Born at Less than Thirty-Four Weeks' Gestation

被引:35
作者
Ahn, Hye Mi [1 ]
Park, Eun Ae [1 ]
Cho, Su Jin [1 ]
Kim, Young-Ju [2 ]
Park, Hye-Sook [3 ]
机构
[1] Ewha Womans Univ, Sch Med, Dept Pediat, Seoul 158710, South Korea
[2] Ewha Womans Univ, Sch Med, Dept Obstet & Gynecol, Seoul 158710, South Korea
[3] Ewha Womans Univ, Sch Med, Dept Prevent Med, Seoul 158710, South Korea
关键词
Chorioamnionitis; Antenatal steroids; Preterm infants; INFLAMMATION; BIRTH; MANAGEMENT; DISEASE; TERM;
D O I
10.1159/000339577
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: Despite continuous research on the prevention of preterm labor, preterm delivery still occurs often. Different neonatal outcomes in association with chorioamnionitis might occur with the introduction of antenatal steroids. Objective: The purpose of this study was to determine the effect of chorioamnionitis on the outcome of preterm infants and the association of antenatal steroids in the presence of histological chorioamnionitis (HC). Methods: Two hundred and fifty-seven infants born at <34 weeks and admitted to Ewha Womans University Hospital from 2005 to 2010 were enrolled. They were divided into 2 groups, one with HC (n = 89) and the other without HC (n = 168). The clinical characteristics and outcomes of the preterm infants including sepsis, respiratory distress syndrome, intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD) were analyzed. Results: HC was associated with IVH (p = 0.019) and early-onset sepsis (p = 0.038). In the HC group, the infants exposed to antenatal steroids developed BPD less than those without steroid exposure. The duration of mechanical ventilation was significantly decreased in the group with antenatal steroids. Conclusion: HC increased the incidence of early-onset sepsis and IVH in preterm infants of less than 34 weeks' gestation with a high odds ratio of 9.54. In the presence of HC, antenatal steroids significantly decreased the incidence of BPD. Copyright (c) 2012 S. Karger AG, Basel
引用
收藏
页码:259 / 264
页数:6
相关论文
共 26 条
[1]   Clinical chorioamnionitis and the prognosis for very low birth weight infants [J].
Alexander, JM ;
Gilstrap, LC ;
Cox, SM ;
McIntire, DM ;
Leveno, KJ .
OBSTETRICS AND GYNECOLOGY, 1998, 91 (05) :725-729
[2]   The Alabama Preterm Birth study: polymorphonuclear and mononuclear cell placental infiltrations, other markers of inflammation, and outcomes in 23- to 32-week preterm newborn infants [J].
Andrews, William W. ;
Goldenberg, Robert L. ;
Faye-Petersen, Ona ;
Cliver, Suzanne ;
Goepfert, Alice R. ;
Hauth, John C. .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2006, 195 (03) :803-808
[3]   Antenatal steroids and neonatal outcome after chorioamnionitis: a meta-analysis [J].
Been, J. V. ;
Degraeuwe, P. L. ;
Kramer, B. W. ;
Zimmermann, L. J. I. .
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2011, 118 (02) :113-122
[4]   Histological chorioamnionitis and respiratory outcome in preterm infants [J].
Been, J. V. ;
Zimmermann, L. J. I. .
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION, 2009, 94 (03) :F218-F225
[5]   Histologic chorioamnionitis, fetal involvement, and antenatal steroids: effects on neonatal outcome in preterm infants [J].
Been, Jasper V. ;
Rours, Ingrid G. I. J. G. ;
Kornelisse, Rene F. ;
Passos, Valeria Lima ;
Kramer, Boris W. ;
Schneider, Tom A. J. ;
de Krijger, Ronald R. ;
Zimmermann, Luc J. I. .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2009, 201 (06) :587.e1-587.e8
[6]   NEONATAL NECROTIZING ENTEROCOLITIS - THERAPEUTIC DECISIONS BASED UPON CLINICAL STAGING [J].
BELL, MJ ;
TERNBERG, JL ;
FEIGIN, RD ;
KEATING, JP ;
MARSHALL, R ;
BARTON, L ;
BROTHERTON, T .
ANNALS OF SURGERY, 1978, 187 (01) :1-7
[7]  
CROWLEY P, 2007, COCHRANE DB SYST REV, V3
[8]   Histologic chorioamnionitis, antenatal steroids, and perinatal outcomes [J].
Elimian, A ;
Verma, U ;
Beneck, D ;
Cipriano, R ;
Visintainer, P ;
Tejani, N .
OBSTETRICS AND GYNECOLOGY, 2000, 96 (03) :333-336
[9]   Clinical management of intra-amniotic infection and chorioamnionitis: A review of the literature [J].
Fahey, Jenifer O. .
JOURNAL OF MIDWIFERY & WOMENS HEALTH, 2008, 53 (03) :227-235
[10]  
Fenton Tanis R, 2003, BMC Pediatr, V3, P13