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目的探讨绒毛膜羊膜炎与早产儿并发症的关系。方法选择2007—2011年本院住院且分娩后行胎盘病理检查的早产儿,按是否存在绒毛膜羊膜炎分为绒毛膜羊膜炎组和非绒毛膜羊膜炎组,绒毛膜羊膜炎患儿按是否合并脐带炎分为脐带炎组和非脐带炎组,比较胎盘病理与母婴并发症的关系。结果共纳入115例早产儿,检出绒毛膜羊膜炎54例(47.0%),其中合并脐带炎14例(12.2%)。绒毛膜羊膜炎组和非绒毛膜羊膜炎组比较,前置胎盘(14.8%比31.1%)、胎盘早剥(5.6%比29.5%)、妊娠合并肝内胆汁淤积(0比11.5%)、呼吸窘迫综合征(5.6%比18.0%)和坏死性小肠结肠炎(1.9%比11.5%)的发生率降低;胎膜早破(46.3%比6.6%)和产前使用抗生素的比例(55.6%比8.2%)升高,P均<0.05。与非脐带炎组比,合并脐带炎组胎儿宫内窘迫、出生时新生儿血CRP、晚发型败血症发生率明显升高;母亲妊娠合并高血压比例降低,产前使用抗生素比例增高,P均<0.05。结论胎膜早破是绒毛膜羊膜炎和(或)脐带炎的高危因素,绒毛膜羊膜炎合并脐带炎时表现胎儿宫内窘迫和出生时CRP升高;绒毛膜羊膜炎不增加呼吸窘迫综合征和坏死性小肠结肠炎的发生率。
Objective To investigate the relationship between chorioamnionitis and complications in premature infants. Methods From 2007 to 2011, our hospital was hospitalized and placenta pathology examination after childbirth premature children, according to the existence of chorioamnionitis is divided into chorioamnionitis group and non-chorioamnionitis group, chorioamnionitis children by whether Umbilical cord inflammation was divided into umbilical cord group and non-umbilical cord group, comparing the relationship between placental pathology and maternal and infant complications. Results A total of 115 preterm infants were included. Chorioamnionitis was detected in 54 (47.0%) cases, of which 14 (12.2%) were associated with umbilical cord inflammation. Compared with non-chorioamnionitis group, placenta accreta (14.8% vs 31.1%), placental abruption (5.6% vs 29.5%), intrahepatic cholestasis of pregnancy (0: 11.5%), The incidence of distress syndrome (5.6% vs 18.0%) and necrotizing enterocolitis (1.9% vs 11.5%) was lower; the rate of premature rupture of membranes (46.3% versus 6.6%) and prenatal antibiotics (55.6% 8.2%) increased, P <0.05. Compared with non-umbilical cord inflammation, fetal umbilical cord embolism with fetal distress, neonatal blood CRP at birth, the incidence of late-onset sepsis was significantly increased; the proportion of mothers with pregnancy reduced hypertension, prenatal use of antibiotics increased the proportion of P < 0.05. Conclusion Premature rupture of membranes is a risk factor for chorioamnionitis and / or umbilical cord inflammation. When chorioamnion is associated with umbilical cord inflammation, fetal distress and elevated CRP at birth are increased. Chorioamnionitis does not increase respiratory distress syndrome And the incidence of necrotizing enterocolitis.