Histological chorioamnionitis, antenatal steroids, and neonatal outcomes in very low birth weight infants: A nationwide study


Autoři: Hyun-Seung Lee aff001;  So Young Kim aff002
Působiště autorů: Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea aff001;  Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea aff002
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224450

Souhrn

Background

The aim of this study was to investigate whether some associations between histological chorioamnionitis (HCA) and favorable neonatal outcomes might be linked to those of antenatal steroids (AS) by determining the separate as well as the combined associations of HCA and AS with neonatal outcomes in very low birth weight infants (VLBWIs).

Methods

This was a population-based study of VLBWIs born at 20–33 weeks’ gestation between January 2013 and December 2015 from the Korean Neonatal Network. A total of 4652 VLBWIs were enrolled for prevalence study. Of these, 2900 singleton VLBWIs were used for outcome analyses to evaluate individual associations of HCA and AS simultaneously with correction for potential perinatal factors and an interaction term of HCA and AS.

Results

The overall prevalence of HCA was 34.9% (1623 VLBWIs). Multivariable logistic regression demonstrated that HCA was associated with decreased mortality (adjusted odds ratio [aOR], 0.51; 95% confidence interval [CI], 0.29–0.91; P = 0.022), AS were associated with reduction in mortality (aOR, 0.59; 95% CI, 0.39–0.90; P = 0.014) and neonatal seizure (aOR, 0.57; 95% CI, 0.37–0.86; P = 0.008), and a combination of HCA and AS was associated with remarkably lowered severe intraventricular hemorrhage by interacting with each other (aOR, 0.47; 95% CI, 0.25–0.88; P = 0.019).

Conclusions

We suggest that in VLBWIs HCA and AS may be favorable independent factors for neonatal outcome and may also work in synergy for neuroprotection.

Klíčová slova:

Birth weight – Death rates – Histology – Infants – Inflammation – Neonatal sepsis – Neonates – Chorioamnionitis


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