Effect of Placental Histological Chorioamnionitis and Prenatal Steroids on the Nervous System of Preterm Infants

IF 0.4 4区医学 Q4 PEDIATRICS

Iranian Journal of Pediatrics Pub Date : 2023-02-10 DOI:10.5812/ijp-121793

Jiao Yuan, Dongqing Zhu, Jie Gu, Fuying Zhao, Yongming Wang, Jingxia Luo

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引用次数: 0

Abstract

Background: The placenta, as a link between mother and fetus, is closely related to the development of the fetal nervous system. Histological chorioamnionitis (HCA) is common placental inflammation and an important factor in triggering premature delivery. Anabolic steroid (AS) is an important medication to promote fetal lung maturity. Therefore, this study investigated the relationship between HCA, AS, and brain injury in premature infants. Objectives: This research aimed to explore the correlation of pathological changes in the placental HCA and the prenatal use of AS with brain injury in preterm infants. Methods: In total, 339 premature infants with a gestational age of under 34 weeks were taken as research subjects, and the placenta was examined by pathology after delivery. The samples were divided into HCA+ AS+, HCA+ AS-, HCA- AS+, and HCA- AS- groups based on the pathological results of the placenta and the prenatal use of steroid hormones. The occurrence of brain injury in preterm infants and the level of inflammatory indicators 2 h after birth were compared between the groups. Results: The incidence of brain injury in preterm infants in the HCA+ group was higher than in the HCA- group (χ2 = 5.713, P < 0.05), and the AS- group than in the AS+ group (χ2 = 4.368, P < 0.05); The incidence of brain injury in the HCA+ AS+, HCA+ AS- and HCA- AS-groups was significantly higher than in the HCA- AS+ group (χ2 = 6.105, P = 0.013; χ2 = 9.086, P = 0.003; χ2 = 4.848, P = 0.047, respectively). The incidence of brain injury in preterm infants was the highest in the group (30%). When the procalcitonin level 2 h after birth was 0.213 ng/mL, sensitivity to predict the occurrence of brain injury in preterm infants was 70.7%, and specificity was 80.2%. Conclusions: Brain damage in premature infants is related to HCA in the mother and insufficient AS treatment before delivery. Brain damage is more likely to occur when both factors exist.

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胎盘组织学绒毛膜羊膜炎和产前类固醇对早产儿神经系统的影响

背景:胎盘作为连接母体和胎儿的纽带，与胎儿神经系统的发育密切相关。组织学绒毛膜羊膜炎(HCA)是常见的胎盘炎症，是引发早产的重要因素。合成代谢类固醇(AS)是促进胎儿肺成熟的重要药物。因此，本研究探讨HCA、AS与早产儿脑损伤的关系。目的:本研究旨在探讨胎盘HCA病理变化与产前使用AS与早产儿脑损伤的相关性。方法:选取胎龄小于34周的早产儿339例为研究对象，分娩后对胎盘进行病理检查。根据胎盘病理结果及产前类固醇激素使用情况，将样本分为HCA+ AS+、HCA+ AS-、HCA- AS+和HCA- AS-组。比较两组早产儿脑损伤发生率及出生后2 h炎症指标水平。结果:HCA+组早产儿脑损伤发生率高于HCA-组(χ2 = 5.713, P <P < 0.05)， AS-组明显高于AS+组(χ2 = 4.368, P <0.05);HCA+ AS+、HCA+ AS-和HCA- AS组脑损伤发生率均显著高于HCA- AS+组(χ2 = 6.105, P = 0.013;χ2 = 9.086, p = 0.003;χ2 = 4.848, P = 0.047)。早产儿脑损伤发生率最高(30%)。出生后2 h降钙素原水平为0.213 ng/mL时，预测早产儿脑损伤发生的敏感性为70.7%，特异性为80.2%。结论:早产儿脑损伤与母亲HCA及产前AS治疗不足有关。当这两种因素同时存在时，更有可能发生脑损伤。

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来源期刊

Iranian Journal of Pediatrics 医学-小儿科

CiteScore

0.90

自引率

20.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.