Correlation Analysis Between Histologic Chorioamnionitis And Periventricular Leukomalacia In Preterm Infants Less Than 34 Weeks Old

ObjectiveTo investigate the correlation between histologic chorioamnionitis(histologic chorioamnionitis,HCA)and periventricular leukomalacia(periventricular leukomalacia,PVL)in preterm infants less than 34 weeks.To judge and intervene the PVL infants who less than 34 weeks and exposed to HCA better than before.Methods1.Infants born in Qingdao Women’s and Children’s Hospital from January 2018 to December 2018,whose mothers had all underwent placental pathological examination,singletons live births,in neonatal intensive care unit for treatment,and whose gestational age was less than 34 weeks,were selected as the study objects.Excluding the cases of mother had infectious diseases,premature infant death and so on.Finally,there is 287 subjects were selected.2.According to the results of placental pathological examination and the patients were divided into two groups:the positive HCA group(167 cases)and the negative HCA group(120 cases).And then,the incidence of PVL was compared between the two groups.3.The preterm infants who had been diagnosed with PVL were divided into three groups according to the stage standard of HCA:the early HCA group and the middle late HCA group,the control group is PVL infants with negative HCA.The differences of PVL severity,general conditions,biochemical indicators,comorbidities and clinical data of mothers were compared among groups.Results1.Comparison of the correlation between HCA and PVL: PVL is 19.16 %(32/167)in the HCA positive group,PVL is 7.50 %(9/120)in the HCA positive group,the incidence of PVL between two groups was statistically significant(P < 0.05).2.The correlation between the severity of HCA and the severity of PVL in different stages: 31.71 %(13 / 41)in the early stage of HCA,46.34 %(19 / 41)in the middle and late stage of HCA,21.95 %(9 / 41)in the control group,the difference was statistically significant(P < 0.05),and there was a positive correlation between the inflammatory infiltration of HCA and the severity of PVL(rs = 0.374,P = 0.016).3.Comparison of clinical data of PVL children: there were statistically significant differences in Apgar score of 1min,white blood cell count at 24 hours after birth,days of antibiotic use,prenatal steroid use,days in hospital,and the occurrence of bronchopulmonary dysplasia among the control group,the early HCA group,and the middle and late HCA groups(c2:4.479、3.921、3.711、11.92、3.670、5.708,P<0.05).4.Follow up comparison of PVL preterm infants: compared with the control group,there was no significant difference in weight and head circumference between the early group and the middle and late group(P > 0.05),and there was significant difference in the evaluation values of mental development index(MDI)and psychomotor development index(PDI)(c2:16.161、3.559,P < 0.05).Conclusion1.A certain correlation exsits between HCA and PVL in preterm infants less than 34 weeks.And a positive correlation with the degree of HCA infiltration.2.Exposure to HCA,a part of clinical parameters of PVL preterm infants with gestational age less than 34 weeks,and Bailey infant test results at the adjusted age of 6months were affected.