5岁时极早产婴儿的组织学绒毛膜羊膜炎和神经发育:EPIPAGE-2队列研究

IF 3.6 2区 医学 Q1 PEDIATRICS
Fanny Salmon, Mathilde Letouzey, Laetitia Marchand-Martin, Héloïse Torchin, Valérie Benhammou, Kaminski Monique, Véronique Pierrat, Laurence Foix-L'Helias, Pierre Yves Ancel, Elsa Lorthe, Gilles Kayem
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引用次数: 0

摘要

目的:探讨无产妇临床症状的组织学绒毛膜羊膜炎与5岁极早产儿神经发育障碍的关系。设计:法国国家前瞻性人群队列研究EPIPAGE-2 (Etude petits gestationnels)。背景:2011年在法国出生的所有22至34周的婴儿都符合条件。人群:早产(PTL)或胎膜早破(PPROMs)后24+0至31+6周出生的婴儿。暴露:无母体临床症状的组织学绒毛膜羊膜炎,又称孤立性组织学绒毛膜羊膜炎,定义为绒毛膜板中存在中性粒细胞,不包括临床绒毛膜羊膜炎。主要结局指标:神经发育障碍,包括脑瘫、发育性协调障碍、感觉障碍、发育性认知缺陷或行为困难在内的复合结局。这些评估是全面的、标准化的,并由训练有素的神经心理学家和儿科医生在5岁时进行。结果:在1296例存活于5岁的儿童中,486例(36.3%)出生时患有孤立性组织学绒毛膜羊膜炎。总体而言,暴露于和未暴露于孤立性组织学绒毛膜羊膜炎的儿童中,47%对33.6%患有轻度神经发育障碍,13.8%对13.3%患有中度至重度神经发育障碍。经过多重归因和多变量分析,发现孤立的组织学绒毛膜羊膜炎与轻度或中度至重度神经发育障碍的发生无关(校正or: 1.0, 95% CI: 0.7 ~ 1.4和0.9、0.6 ~ 1.2)。结论:我们没有发现孤立的组织学绒毛膜羊膜炎与在PTL或PPROM后出生的早产儿5岁时神经发育障碍有任何关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Histological chorioamnionitis and neurodevelopment at 5 years of age among infants born very preterm: EPIPAGE-2 cohort study.

Objective: To assess the association between histological chorioamnionitis without maternal clinical symptoms and neurodevelopmental disabilities at age 5 years in children born very preterm.

Design: French national prospective population-based cohort study, EPIPAGE-2 (Etude épidémiologique sur les petits âges gestationnels).

Setting: All births from 22 to 34 weeks of gestational age in France in 2011 were eligible.

Population: Infants born alive between 24+0 and 31+6 weeks following preterm labour (PTL) or preterm premature rupture of membranes (PPROMs).

Exposure: Histological chorioamnionitis without maternal clinical symptoms, also called isolated histological chorioamnionitis, was defined as the presence of neutrophils in the chorionic plate, excluding clinical chorioamnionitis.

Main outcome measures: Neurodevelopmental disabilities, a composite outcome including cerebral palsy, developmental coordination disorders, sensory impairment, developmental cognitive deficiencies or behavioural difficulties. These assessments were comprehensive, standardised and conducted by trained neuropsychologists and paediatricians at age 5 years.

Results: Among 1296 children alive at 5 years of age, 486 (36.3%) were born in a context of isolated histological chorioamnionitis. Overall, 47% vs 33.6% of children exposed and not exposed to isolated histological chorioamnionitis had mild neurodevelopmental disabilities, and 13.8% vs 13.3% had moderate-to-severe neurodevelopmental disabilities. After multiple imputation and multivariable analysis, isolated histological chorioamnionitis was found not to be associated with the occurrence of mild or moderate-to-severe neurodevelopmental disabilities (adjusted OR: 1.0, 95% CI: 0.7 to 1.4 and 0.9, 0.6 to 1.2).

Conclusion: We did not find any association between isolated histological chorioamnionitis and neurodevelopmental disabilities at age 5 years in children born very preterm after PTL or PPROM.

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来源期刊
CiteScore
9.00
自引率
4.50%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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