Chorioamnionitis and lung damage in the extremely low birth weight infant
Gustavo Rocha1
Elisa Proença2
Conceição Quintas3
Teresa Rodrigues4
Hercília Guimarães5
Resumo
]]> Alguns estudos experimentais sugerem que a exposição a infecção intra-uterina associa-se, não só, a maturação pulmonar e menor risco de doença das membranas hialinas, mas também a atraso na formação alveolar e maior risco de displasia broncopulmonar. Objectivo: Avaliar a associação entre corioamnionite histológica e lesão pulmonar no recém-nascido pré-termo de extremo baixo peso. Métodos: Estudo retrospectivo em 63 recém-nascidos com peso ao nascimento inferior a 1000 g, apropriados à idade gestacional, nascidos em três centros hospitalares do Norte de Portugal, entre 2001 e 2002. A associação entre corioamnionite histológica e lesão pulmonar (doença das membranas hialinas e displasia broncopulmonar) foi avaliada através do cálculo de odds ratio. Resultados: Em 32 recém-nascidos as mães apresentaram corioamnionite histológica e em 31 a condição não estava presente. A associação entre corioamnionite histológica e doença das membranas hialinas foi OR 0,23 (IC 95% 0,01 – 2,51). A associação entre corioamnionite histológica e displasia broncopulmonar foi OR 1,61 (IC 95% 0,38 – 6,97). A associação entre corioamnionite histológica e displasia broncopulmonar ajustada para a idade gestacional, gestação múltipla e parto por cesariana não foi estatisticamente significativa: OR 2,66 (IC 95% 0,36 – 19,60) para orioamnionite sem funisite ou vasculite e OR 1,68 (IC 95% 0,25 – 11,18) para corioamnionite com funisite e/ou vasculite. Conclusão: Este estudo não nos permitiu confirmar a existência de menor risco de doença das membranas hialinas ou de maior risco de displasia broncopulmonar no recém-nascido pré-termo de extremo baixo peso com corioamnionite histológica.Palavras-chave: Corioamnionite, displasia broncopulmonar, doença das membranas hialinas.
Abstract
Some experimental work suggests that exposure to intrauterine infection is associated, not only, with lung maturation and a reduced risk of respiratory distress syndrome, but also, with delayed alveolarization and increased risk of bronchopulmonary dysplasia. Aim: To evaluate the association between histological chorioamnionitis and lung disease in extremely low birth weight preterm infants. Methods: A retrospective chart review of 63 less than 1000 g birthweight, appropriated for gestational age neonates, delivered at three tertiary medical centers in the north of Portugal, between 2001 and 2002. The association between histological chorioamnionitis and lung damage (respiratory distress syndrome and bronchopulmonary dysplasia) was evaluated through the calculation of crude and adjusted odds ratio. Results: There were 32 newborns from mothers with histological chorioamnionitis and 31 without the condition. The association between histological chorioamnionitis and respiratory distress syndrome was OR 0.23 (95% CI 0.01 – 2.51). The association between chorioamnionitis and bronchopulmonary dysplasia was OR 1.61 (95% CI 0.38 – 6.97). The association between histological chorioamnionitis and bronchopulmonary dysplasia when adjusted for gestational age, multiple birth and C-section revealed no statistical significance: OR 2.66 (95% CI 0.36 – 19.60) for chorioamnionitis without funisitis or vasculitis and OR 1.68 (95% CI 0.25 – 11.18) for funisitis and/or vasculitis. Conclusion: In this study we could not confirm a decreased risk of respiratory distress syndrome nor an increased risk of bronchopulmonary dysplasia in extremely low birth weight preterm neonates with histological chorioamnionitis.
Key-words: Chorioamnionitis, bronchopulmonary dysplasia, respiratory distress syndrome.
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1Assistente Hospitalar. Pediatric Department, Division of Neonatology, Hospital de São João, University Hospital
2Assistente Hospitalar. Pediatric Department, Maternidade Júlio Dinis
3Assistente Hospitalar. Pediatric Department, Division of Neonatology, Centro Hospitalar de Vila Nova de Gaia
4Assistente Hospitalar. Obstetrics and Gynecology Department, Epidemiology Department, Hospital de São João, University Hospital
5Chefe de Serviço. Pediatric Department, Division of Neonatology, Hospital de São João, University Hospital
]]> Correspondência / Correspondence:
Gustavo Rocha
Serviço de Neonatologia / Departamento de Pediatria
Hospital de São João – Piso 2
Alameda Prof. Hernâni Monteiro
4202 – 451 Porto
Portugal
Tel: +351 225095816
Fax: +351225512273
E-mail: gusrocha@oninet.pt
]]>Recebido para publicação/received for publication: 06.02.10
Aceite para publicação/accepted for publication: 07.03.26
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