1. Is there a stepwise increase in neonatal morbidities according to histological stage (or grade) of acute chorioamnionitis and funisitis?: effect of gestational age at delivery.
- Author
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Yeri Lee, Hyun-Joo Kim, Suk-Joo Choi, Soo-young Oh, Jung-Sun Kim, Cheong-Rae Roh, and Jong-Hwa Kim
- Subjects
PLACENTA physiology ,ACADEMIC medical centers ,ANALYSIS of variance ,CEREBRAL hemorrhage ,BRONCHOPULMONARY dysplasia ,CHI-squared test ,DELIVERY (Obstetrics) ,FETAL diseases ,GESTATIONAL age ,MULTIVARIATE analysis ,PREGNANCY complications ,RESEARCH funding ,RESPIRATORY distress syndrome ,RETROLENTAL fibroplasia ,STATISTICS ,DISEASE incidence ,RETROSPECTIVE studies ,DESCRIPTIVE statistics ,KRUSKAL-Wallis Test - Abstract
Aims: To test if there is a stepwise difference in neonatal outcomes according to the stage (or grade) of histological inflammatory response in the chorioamniotic membranes and umbilical cords of preterm premature rupture of membranes (PPROM). Method: This retrospective study included singleton pregnancies diagnosed as PPROM and delivered prior to 34 weeks of gestation (n=339). Acute histological chorioamnionitis and funisitis were subdivided into stages (or grade) as defined by Redline et al. Neonatal composite morbidities and mortality were also monitored. Univariate and multivariate analyses were conducted. Results: Increasing stage (or grade) of acute histological chorioamnionitis and funisitis was significantly associated with an earlier gestational age at membrane rupture and delivery. Among neonatal outcomes, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), intraventricular hemorrhage, retinopathy of prematurity, and composite morbidity showed incremental incidence according to increased stage (or grade) of acute chorioamnionitis, while periventricular leukomalacia and necrotizing enterocolitis did not. Only RDS, BPD, and composite morbidity showed similar incremental incidences associated with severity of funisitis stage. However, the incremental trends of each neonatal outcome were found to be nonsignificant by multivariate analysis adjusting confounding variables including gestational age at delivery. Conclusion: Higher incidences of neonatal morbidity according to increased stage (or grade) of either acute histological chorioamnionitis or funisitis were due to an earlier gestational age at delivery. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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