Correlation Analysis Of Placental Histology Between Chorioamnionitis And Respiratory Distress Syndrome In Preterm

Objective:Through the retrospective analysis of maternal and infant clinical data,Hemochonitis(histologic chorioamnionitis,HCA)and neonatal respiratory distress syndrome(Respiratory Distress Syndrome of Newborn,NRDS)was investigated.And to explore whether HCA at different stages was associated with the severity of NRDS.The risk factors of NRDS were analyzed according to the relevant data.Methods:Data of preterm infants and their mothers hospitalized to the First Affiliated Hospital of Dali University from January 2019 to December 2022 were then retrospectively analyzed.According to the inclusion criteria and exclusion criteria,277 cases were selected,and the clinical data of each child and her mother were recorded accurately and in detail with Excel 2016.According to the placentation disease,the HCA was divided into HCA group and control group.The HCA group was divided into mild group,moderate group,and severe group according to the pathological stage results.Gestational age,birth weight,sex,maternal age,mode of delivery,birth score,maternal prenatal use of antibiotics or hormones,and the incidence of NRDS in premature infants were compared,and HCA and NRDS severity at different stages were analyzed.And analyze the associated risk factors of NRDS.Statistical analysis was performed using the SPSS 26.0 software.Measurement data in line with the normal distribution are expressed asx?s,independent sample t test was used for comparison between two groups,one-way analysis of variance was used for comparison between multiple groups,non-normal measurement data were expressed as M(P25,P75),Mann-Whitney U test was used for comparison between two groups,and K-W rank sum test was used for comparison between multiple groups.Count data are presented as cases(%),and groups are compared byχ~2test or Fisher exact probability method.Correlation analysis of bidirectional order rank data was performed using the Spearman rank correlation test.Whether NRDS occurred was used as the dependent variable,and independent variables that might have clinical significance were selected for univariate analysis to clarify whether they were statistically significant.Statistically significant independent variables were then selected for multivariate logistic regression analysis.Results:After the data of 227 premature infants were divided into HCA positive and negative groups,the HCA negative group was compared with the HCA positive group through the analysis of the general data of premature infants.There were statistically significant differences in the incidence of NRDS,cesarean delivery rate,prenatal use of antibiotics.The difference in the age of the mother;whether it is a primimother and some pregnancy complications,which may be related to the small sample size.A total of 145 cases of all premature infants with NRDS were counted.According to the placental pathology results,they were divided into HCA negative group,HCA early stage group,middle stage group and late stage group,with statistically significant differences in gestational age at birth,birth weight and maternal prenatal use of antibiotics.A total of 93 cases of Hmothers in HCA were counted,which were divided into early stage group,middle stage group and late stage HCA group.According to the results of the chest X-ray,it was divided into NRDS negative groups,and five groups:NRDS I,NRDS II,NRDS III and NRDS IV.They were compared by Spearman rank correlation.It is concluded that there was no statistical difference in premature NRDS severity and HAC stage.The collected 277 preterm infants,divided into NRDS positive and NRDS negative groups,showed statistically significant differences in gestational age at birth,birth weight,cesarean delivery,neonatal asphyxia,premature rupture of membranes,primiparous mother,and mothers with hypertensive diseases.In order to improve the test efficiency,eliminate the interference of confounding factors,the confounders were corrected and predicted and identified.The significant indicators in univariate analysis were analyzed to Logistic multivariate regression analysis.The final analysis concluded that the younger the gestational age at birth,cesarean section,and the absence of HCA were independent risk factors for NRDS.Conclusion:1.Maternal HCA can reduce the incidence of respiratory distress syndrome in premature infants.And different levels of HCA are protective factors for respiratory distress syndrome.Maternal hypertension is associated with the development of NRDS.2.Small gestational age,low birth weight,caesarean section,asphyxia of premature infants,premature rupture of membranes,3,the smaller the gestational age,the delivery mode is caesarean section,and the mother does not suffer from HCA are independent risk factors for NRDS.4.For pregnant mothers with premature rupture of membranes,prenatal use of antibiotics may have a certain effect on the prevention of chorionic amnitis.