{"title":"极低出生体重儿绒毛膜羊膜炎的神经发育结局。","authors":"Shu-Chi Mu, Cheng-Hui Lin, Tseng-Chen Sung, Yi-Ling Chen, Yi-Chieh Lin, Chin-Cheng Lee, Tong-Jong Chen, Ming-I Lin, Guey-Mei Jow","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chorioamnionitis (CAM) is one of the main causes of preterm labor and has been associated with an adverse perinatal outcome in preterm infants.</p><p><strong>Objective: </strong>The specific aim of our study was to evaluate whether there is significant difference in the Bayley developmental index scores at 6, 12, 18 and 24 months of corrected age for very-low-birthweight (birth body weight <1500 gm, VLBW) infants with or without placental CAM.</p><p><strong>Methods: </strong>Ninety-five cases (54 in CAM and 41 in non-CAM groups) available for the study were all VLBW infants with adequate histologic placental material for analysis. Neonatal characteristics and morbidities were recorded. The infants were followed up prospectively with Bayley Scales of Infant Development in the Neonatal Follow-up Clinic for 2 years.</p><p><strong>Results: </strong>We found that 56.8% of placentas presented a picture of CAM. In comparison of the neonatal characteristics, VLBW infants with CAM had shorter gestational age (27.9 +/- 2.8 vs. 30.0 +/- 3.7 weeks, p = 0.003), lower Cesarean delivery rate (48.1% vs. 73.2%, p = 0.011), more maternal steroid use (44.4% vs. 12.2%, p = 0.004) and higher incidence of preterm premature rupture of membrane (PPROM, 37.0% vs. 12.2%, p = 0.009). In comparison of neonatal outcomes, the CAM group had higher incidence of bronchopulmonary dysplasia (BPD, 40.7% vs. 19.5%, p = 0.044), more mechanical ventilation (87.0% vs. 27/41, p = 0.023) and intubation (68.5% vs. 46.3%, p = 0.049), and more median days of ventilation (23.1 +/- 29.1 vs. 7.8. +/- 13.7 days, p = 0.001). As for the follow-up, at any test age, either the mean (Mental Development Index (MDI) / (Psychomotor Development Index (PDI) scores of Bayley test or the incidence of score below 85, there was no significant difference in both groups.</p><p><strong>Conclusions: </strong>The VLBW infants with histologic chorioamnionitis were not associated with an increased risk of lower MDI or PDI scores at the corrected ages of 6, 12, 18 and 24 months compared with the non-CAM control group.</p>","PeriodicalId":7156,"journal":{"name":"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Neurodevelopmental outcome of very-low-birth-weight infants with chorioamnionitis.\",\"authors\":\"Shu-Chi Mu, Cheng-Hui Lin, Tseng-Chen Sung, Yi-Ling Chen, Yi-Chieh Lin, Chin-Cheng Lee, Tong-Jong Chen, Ming-I Lin, Guey-Mei Jow\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Chorioamnionitis (CAM) is one of the main causes of preterm labor and has been associated with an adverse perinatal outcome in preterm infants.</p><p><strong>Objective: </strong>The specific aim of our study was to evaluate whether there is significant difference in the Bayley developmental index scores at 6, 12, 18 and 24 months of corrected age for very-low-birthweight (birth body weight <1500 gm, VLBW) infants with or without placental CAM.</p><p><strong>Methods: </strong>Ninety-five cases (54 in CAM and 41 in non-CAM groups) available for the study were all VLBW infants with adequate histologic placental material for analysis. Neonatal characteristics and morbidities were recorded. The infants were followed up prospectively with Bayley Scales of Infant Development in the Neonatal Follow-up Clinic for 2 years.</p><p><strong>Results: </strong>We found that 56.8% of placentas presented a picture of CAM. In comparison of the neonatal characteristics, VLBW infants with CAM had shorter gestational age (27.9 +/- 2.8 vs. 30.0 +/- 3.7 weeks, p = 0.003), lower Cesarean delivery rate (48.1% vs. 73.2%, p = 0.011), more maternal steroid use (44.4% vs. 12.2%, p = 0.004) and higher incidence of preterm premature rupture of membrane (PPROM, 37.0% vs. 12.2%, p = 0.009). In comparison of neonatal outcomes, the CAM group had higher incidence of bronchopulmonary dysplasia (BPD, 40.7% vs. 19.5%, p = 0.044), more mechanical ventilation (87.0% vs. 27/41, p = 0.023) and intubation (68.5% vs. 46.3%, p = 0.049), and more median days of ventilation (23.1 +/- 29.1 vs. 7.8. +/- 13.7 days, p = 0.001). As for the follow-up, at any test age, either the mean (Mental Development Index (MDI) / (Psychomotor Development Index (PDI) scores of Bayley test or the incidence of score below 85, there was no significant difference in both groups.</p><p><strong>Conclusions: </strong>The VLBW infants with histologic chorioamnionitis were not associated with an increased risk of lower MDI or PDI scores at the corrected ages of 6, 12, 18 and 24 months compared with the non-CAM control group.</p>\",\"PeriodicalId\":7156,\"journal\":{\"name\":\"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2007-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:绒毛膜羊膜炎(CAM)是早产的主要原因之一，并与早产儿的不良围产期结局有关。目的:本研究的具体目的是评估极低出生体重(出生体重)在校正年龄6、12、18和24个月时Bayley发育指数评分是否存在显著差异。方法:95例(54例CAM组和41例非CAM组)均为具有足够胎盘组织材料进行分析的VLBW婴儿。记录新生儿特征和发病率。采用Bayley婴儿发育量表在新生儿随访诊所进行前瞻性随访2年。结果:56.8%的胎盘出现CAM图像。在新生儿特征比较中，患有CAM的VLBW婴儿胎龄较短(27.9 +/- 2.8周vs. 30.0 +/- 3.7周，p = 0.003)，剖宫产率较低(48.1% vs. 73.2%， p = 0.011)，母亲使用类固醇较多(44.4% vs. 12.2%， p = 0.004)，早产早破膜发生率较高(PPROM, 37.0% vs. 12.2%， p = 0.009)。在新生儿结局方面，CAM组支气管肺发育不良发生率更高(BPD, 40.7%比19.5%，p = 0.044)，机械通气(87.0%比27/41,p = 0.023)和插管(68.5%比46.3%，p = 0.049)，中位通气天数更长(23.1 +/- 29.1比7.8)。+/- 13.7天，p = 0.001)。随访方面，在任何测试年龄，无论是Bayley测验(Mental Development Index, MDI) / (Psychomotor Development Index, PDI)的均分还是低于85分的发生率，两组间均无显著差异。结论:与非cam对照组相比，患有组织学绒毛膜羊膜炎的VLBW婴儿在校正后6、12、18和24个月时MDI或PDI评分较低的风险增加无关。
Neurodevelopmental outcome of very-low-birth-weight infants with chorioamnionitis.
Background: Chorioamnionitis (CAM) is one of the main causes of preterm labor and has been associated with an adverse perinatal outcome in preterm infants.
Objective: The specific aim of our study was to evaluate whether there is significant difference in the Bayley developmental index scores at 6, 12, 18 and 24 months of corrected age for very-low-birthweight (birth body weight <1500 gm, VLBW) infants with or without placental CAM.
Methods: Ninety-five cases (54 in CAM and 41 in non-CAM groups) available for the study were all VLBW infants with adequate histologic placental material for analysis. Neonatal characteristics and morbidities were recorded. The infants were followed up prospectively with Bayley Scales of Infant Development in the Neonatal Follow-up Clinic for 2 years.
Results: We found that 56.8% of placentas presented a picture of CAM. In comparison of the neonatal characteristics, VLBW infants with CAM had shorter gestational age (27.9 +/- 2.8 vs. 30.0 +/- 3.7 weeks, p = 0.003), lower Cesarean delivery rate (48.1% vs. 73.2%, p = 0.011), more maternal steroid use (44.4% vs. 12.2%, p = 0.004) and higher incidence of preterm premature rupture of membrane (PPROM, 37.0% vs. 12.2%, p = 0.009). In comparison of neonatal outcomes, the CAM group had higher incidence of bronchopulmonary dysplasia (BPD, 40.7% vs. 19.5%, p = 0.044), more mechanical ventilation (87.0% vs. 27/41, p = 0.023) and intubation (68.5% vs. 46.3%, p = 0.049), and more median days of ventilation (23.1 +/- 29.1 vs. 7.8. +/- 13.7 days, p = 0.001). As for the follow-up, at any test age, either the mean (Mental Development Index (MDI) / (Psychomotor Development Index (PDI) scores of Bayley test or the incidence of score below 85, there was no significant difference in both groups.
Conclusions: The VLBW infants with histologic chorioamnionitis were not associated with an increased risk of lower MDI or PDI scores at the corrected ages of 6, 12, 18 and 24 months compared with the non-CAM control group.
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