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Published on: November 20, 2015
Risk factors for and short-term prognosis of intrauterine infection in preterm infants
Xuemei Zhao1, Yue Song2, Liqun Lu2
1Department of Pediatrics, Xindu District People's Hospital, Chengdu, Sichuan Province, China.
Insights
Intrauterine infection (IUI) in preterm infants is linked to significant complications and mortality. Risk factors include maternal procedures and prolonged membrane rupture, with inflammation severity worsening outcomes.
Area of Science:
- Neonatalogy
- Perinatology
- Infectious Diseases
Background:
- Intrauterine infection (IUI) poses a significant threat to preterm infants.
- Understanding risk factors and prognosis is crucial for improving neonatal outcomes.
Purpose of the Study:
- To identify risk factors for intrauterine infection (IUI) in preterm infants.
- To determine the short-term prognosis of preterm infants diagnosed with IUI.
Main Methods:
- Retrospective collection of clinical data from preterm infants (28-36 weeks GA) with IUI.
- Classification of pathologic characteristics using Redline criteria.
- Comparison of clinical characteristics, infection indicators, complications, and mortality rates.
Main Results:
- Histologic IUI was present in 78.1% of enrolled neonates.
- Independent risk factors included maternal prenatal invasive manipulation, premature rupture of membranes (>18 hours), and elevated prenatal C-reactive protein.
- IUI infants had higher rates of respiratory distress syndrome, bronchopulmonary dysplasia, retinopathy of prematurity, and prolonged mechanical ventilation.
- Lower gestational age and birth weight correlated with higher IUI incidence, inflammation severity, and complications.
Conclusions:
- Histologic IUI is associated with elevated complication and mortality rates in preterm infants.
- Increasing inflammation severity in IUI correlates with poorer outcomes.
Objective:
To identify the risk factors for and short-term prognosis of intrauterine infection (IUI) in preterm infants.
Methods:
We retrospectively collected clinical data regarding preterm infants (28+0-36+6 weeks of gestational age) with IUI from the neonatal intensive care unit of our hospital between June 2017 and June 2022. The pathologic characteristics of the infants were classified using the Redline criteria, and the resulting groups were compared with respect to their clinical characteristics, indicators of infection, complications, and mortality rates.
Results:
Three hundred thirty (78.1%) of the 422 enrolled neonates showed signs of histologic IUI; 51.8% showed histologic chorioamnionitis alone, and 48.2% showed both histologic chorioamnionitis and funisitis. The independent risk factors identified for IUI were maternal prenatal invasive manipulation, premature rupture of membranes (>18 hours before labor), and prenatal C-reactive protein concentration. The infants with IUI showed higher incidences of respiratory distress syndrome, bronchopulmonary dysplasia, retinopathy of prematurity, and prolonged mechanical ventilation. Low gestational age and low birth weight of preterm infants were significantly associated with a higher incidence of histologic IUI, more severe inflammation, and a higher incidence of complications.
Conclusions:
Histologic IUI is associated with high complication and mortality rates in preterm infants, as is an increasing severity of inflammation.
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