胎盘组织学绒毛膜羊膜炎与未足月胎膜早破后早产儿脑损伤关系

目的:研究胎盘组织学绒毛膜羊膜炎与未足月胎膜早破后早产儿出现脑损伤的相关性。方法:选取我院妇产科2017年1月至2019年12月收治的因胎膜早破生产的未足月早产儿80例,根据是否存在绒毛膜羊膜炎分为观察组(绒毛膜羊膜炎)和对照组(无绒毛膜羊膜炎),每组40例,患儿于胎龄40 w时行颅脑核磁共振检查(Magnetic Resonance Examination,MRI),对比两组脑室周围白质软化(periventricular leukomalacia,PVL)阳性率,且采用新生儿20项行为神经评分量表(neonatal behavior neurological assessment,NBNA)评价两组患儿神经行为,然后在纠正胎龄3、6个月时对两组患儿进行智能发育指数(mental developmentalindex,MDI)及心理运动发育指数(psychomotor development index,PDI)测定并对比。结果:观察组PVL阳性率为27.5%,高于对照组的10.0%(P<0.05);观察组纠正胎龄40 w NBNA得分为(31.02±3.51)分,对照组为(35.21±4.02)分,差异具有统计学意义(P<0.05);胎龄3个月,MDI得分在观察组与对照组间差异无具有统计学意义(P>0.05),但其PDI得分低于对照组(P<0.05);胎龄6个月,观察组MDI及PDI得分均低于对照组(P<0.05)。结论:绒毛膜羊膜炎与未足月胎膜早破后早产儿的脑部损伤情况具有一定相关性,可以作为预测早产儿脑损伤程度的一项指标。

The Relationship between Placental Histology Chorioamnionitis and Brain Damage in Preterm Infants after Preterm Rupture of Membranes

ABSTRACT Objective: To study the correlation between placental histology, chorioamnionitis, and brain damage in preterm infants after preterm rupture of membranes. Methods: 80 cases of preterm infants born due to premature rupture of membranes treated in our obstetrics and gynecology department from January 2017 to December 2019 were selected and divided into observation group (chorioamnionitis) and chorioamnionitis based on the presence or absence of chorioamnionitis and In the control group (non chorioamnionitis), 40 patients in each group received craniocerebral MRI at 40 weeks of gestational age, compared the PVL positive rate between the two groups, and evaluated the neurobehavior of the two groups with 20 NBNA of newborns Then at the correct gestational age of 3 and 6 months, MDI and PDI were measured and compared between the two groups of children. Results: The positive rate of PVL in the observation group was 27.5 %, which was higher than 10.0 % in the control group, and the difference was statistically significant (P<0.05). The corrected NBNA score of the observation group at 40 weeks was (31.02±3.51) points, and the control group was (35.21±4.02) points. The difference was statistically significant (P<0.05). At 3 months of gestational age, there was no significant difference in MDI score between the observation group and the control group (P>0.05), but its PDI score was lower than Control group (P<0.05). MDI and PDI scores in observation group were lower than those in control group (P<0.05). Conclusion: Chorioamnionitis and brain damage in preterm infants with preterm premature rupture of membranes have a certain correlation, which can be used as an index to predict the degree of brain damage in preterm infants.