Analysis on the association of risks related to maternal factors and placental inflammation with necrotizing enterocolitis in preterm infants
10.3760/cma.j.issn.1008-1372.2017.06.014
- VernacularTitle:母体风险因素和胎盘炎症性病变与早产儿坏死性小肠结肠炎的关系分析
- Author:
Juanjuan HUANG
;
Hua LI
;
Liping ZHANG
;
Juan ZHANG
;
Xia GAO
- Keywords:
Placenta diseases/CO;
Enterocolitis,necrotizing/CO
- From:
Journal of Chinese Physician
2017;19(6):848-851
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the association of risks related to maternal factors with the subsequent development of necrotizing enterocolitis (NEC) in very preterm infants and to determine whether the placental inflammatory lesions were also related to the NEC.Methods This retrospective cohort study examined newborns born at < 32 weeks (n =180) between July 2006 and July 2015 and their mothers at our hospital,recorded the maternal age,body mass index (BMI),multiparity situation,and the usage of prenatal steroids or antibiotics.Medical records of eligible newborns and their mothers were reviewed.Maternal blood white blood cell and differential counts were measured at admission and the placentas were examined histologically after delivery.The primary outcome measure was NEC Bell Stage Ⅱ a.Bivariate analyses and multivariate logistic regression were used for the statistical analyses.Results NEC was diagnosed in 14 of 180 very preterm infants (7.8%),including 11 Stage Ⅱ and 3 Stage Ⅲ infants,and the overall mortality rate of these infants was 7.1% (n =1).Multivariate regression analysis identified maternal neutrophil-to-lymphocyte ratio (OR =1.07,P =0.002),muhiparity (OR =3.39,P =0.013),and birth weight (OR =0.06,P =0.01) were significantly associated with an increased risk of NEC development.Neonatal neutrophil-to-lymphocyte ratio (NLR) as measured within 24 hours of birth (P =0.65) was not associated with NEC development.Clinical chorioamnionitis (P≥0.99) and histological chorioamnionitis (P =0.46) and funisitis (P =0.21) could not be used as significant predictors of NEC.Conslusions The development of NEC in very preterm infants is associated with the maternal NLR,parity,and birth weight,not with clinical and histological chorioamnionitis and funisitis.