The Relationship between Histological Chorioamnionitis and Bronchopulmonary Dysplasia in Low-Birth Weight Infants: Changes of C-Reactive Protein in Bronchopulmonary Dysplasia

Kyungju Kim, Ji Won Jang, Ji Hyeon Moon, Jeonghee Shin, Eun Hee Lee, Byung Min Choi, Young Sook Hong, Min Jeong Oh
2019 Perinatology  
Objective: Intrauterine inflammation caused by chorioamnionitis has been related with various peri natal morbidities which increase the risk of bronchopulmonary dysplasia (BPD). Creactive protein (CRP) is a well known biomarker of inflammation. We aimed to investigate the relationship between histological chorioamnionitis (HCA) and BPD, and also to observe the changes of CRP in BPD. Methods: Lowbirthweight infants (LBWIs) admitted to the neonatal intensive care unit between January 2011 and
more » ... anuary 2011 and October 2017 were reviewed. Perinatal morbidities associated with BPD including maternal HCA were observed. Also, changes of CRP were analyzed. Results: A total of 584 LBWIs were analyzed and 168 (28.8%) had HCA and 46 (7.9%) had BPD. The development of BPD was associated with gestational age, birth weight, 1 and 5 minutes Apgar scores, the presence of preterm premature rupture of membrane, prenatal antibiotics, respiratory distress syndrome (RDS), ventilator application, early onset sepsis, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, patent ductus arteriosus and HCA. The multiple logistic regression model for BPD showed that the risk factors of BPD were lower gestational age, lower birth weight, patent ductus arteriosus (PDA). Chorioamnionitis was not a significant risk factor for BPD (aOR, 1.477; 95% CI, 0.3765.806). Infants with BPD were likely to have higher CRP on day 0 and day 7. Conclusion: Our study suggests that the primary risk factors of BPD in LBWIs are lower gestational age, lower birth weight, RDS, ventilator application and PDA rather than HCA. In infants with BPD, CRP was significantly higher on day 0 and day 7. 서론 기관지폐 형성이상(bronchopulmonary dysplasia, BPD)은 미숙아 및 저체중아에서 많이 발생하는 만성 폐질환으로서, 미숙아의 생존율이 증가함에 따라 그 발생률도 증가하고 있다. 이는 폐에서 폐포와 혈관의 발달이 억제되어 발생하며 출생 전후기의 염증과 관련된다고 알 려져 있다. 1,2 퇴원 후에도 지속적인 산소흡입, 반복적인 호흡기 감염이나 그로 인한 재입원 을 필요로 할 뿐 아니라, 신경발달에도 영향을 미친다는 보고가 있으므로 3,4 위험인자의 예측 을 통한 예방이 중요하다. 5 조직학적 융모양막염은 산모의 염증 반응으로서 양막, 융모막, 융모막판에 호중구가 침윤 된 경우이며 제대혈관의 염증(funisitis) 등 태아의 염증이 동반되기도 한다. 2,6 미숙아의 25-40%가 자궁내 염증과 관련이 있다. 7 최근 태반의 조직검사 시행이 증가함에 따라 병리학적으로 증명된 융모양막염과 신생아 의 여러 질환과의 관계에 대한 연구가 늘어나면서 태아기의 자궁내 염증이 신생아의 예후에
doi:10.14734/pn.2019.30.1.8 fatcat:h4o4bn6v3ne2dhlnx3ynmqzn6i