期刊
JOURNAL OF PERINATAL MEDICINE
卷 46, 期 1, 页码 9-20出版社
WALTER DE GRUYTER GMBH
DOI: 10.1515/jpm-2016-0348
关键词
Brain injury; hypoxic-ischemic injury; intra-amniotic inflammation; periventricular-intraventricular hemorrhage; preterm birth
资金
- Korea government (MEST) [2011-0000195]
- Seoul National University Bundang Hospital Research Fund [11-2011-018]
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics
- NICHD/NIH/DHHS [HHSN275201300006C]
Objective: To evaluate the impact of combined exposure to intra-amniotic inflammation and neonatal respiratory distress syndrome (RDS) on the development of intraventricular hemorrhage (IVH) in preterm neonates. Methods: This retrospective cohort study includes 207 consecutive preterm births (24.0-33.0 weeks of gestation). Intra-amniotic inflammation was defined as an amniotic fluid matrix metalloproteinase-8 concentration > 23 ng/mL. According to McMenamin's classification, IVH was defined as grade II or higher when detected by neurosonography within the first weeks of life. Results: (1) IVH was diagnosed in 6.8% (14/207) of neonates in the study population; (2) IVH was frequent among newborns exposed to intra-amniotic inflammation when followed by postnatal RDS [33% (6/18)]. The frequency of IVH was 7% (8/115) among neonates exposed to either of these conditions - intra-amniotic inflammation or RDS and 0% (0/64) among those who were not exposed to these conditions; and (3) Neonates exposed to intra-amniotic inflammation and postnatal RDS had a significantly higher risk of IVH than those with only intra-amniotic inflammation [odds ratio (OR) 4.6, 95% confidence interval (CI) 1.1-19.3] and those with RDS alone (OR 5.6, 95% CI 1.0-30.9), after adjusting for gestational age. Conclusion: The combined exposure to intra-amniotic inflammation and postnatal RDS markedly increased the risk of IVH in preterm neonates.
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