Correlation Between Histologic Chorioamnionitis And Bronchopulmonary Dysplasia In Preterm Infants Aged <34 Weeks

Objective: The aim of this study was to investigate the correlation between histological chorioamnionitis(HCA)and the incidence of bronchopulmonary dysplasia(BPD)and the correlation between stages of HCA and severity of BPD in premature labor.Methods:Retrospective selection of premature infants with a gestational age of <34weeks who gave birth in Qingdao Women and Children’s Hospital and were admitted to the Department of Neonatology from August 2017 to January 2019.All mothers of preterm infants have no infectious disease.Premature infants are divided into HCA negative group and HCA positive group according to the results of placental pathological examination.Compare the incidence and severity of BPD in each group.According to placental pathological examination and its staging,premature infants who have been diagnosed with BPD are divided into non-HCA group,early HCA group and middle-late HCA group to compare the differences in BPD severity,general conditions,infection indicators,respiratory support and major comorbidities.Results:(1)There were 361 cases in total,206 cases in HCA positive group,155 cases in HCA negative group.The incidence of BPD in the two groups was 20.4% and 8.4%.There is statistical significance between HCA positive group and HCA negative group.(P <0.05).(2)There were 55 cases diagnosed with BPD,24 in early HCA group,and 18 in middle-late HCA group.There is no statistical significance between the HCA stage and the severity of BPD(P> 0.05).(3)The count of WBC、 CRP in mothers in the early HCA group and the middle-late HCA groups were greater than those in the non-HCA group;The count of CRP in the middle-late HCA groups is greater than that in the early and non-HCA groups(P <0.05);there was no significant difference in mother age,premature rupture of membranes,and antenatal dexamethasone use in each group(P> 0.05).(4)The gestational age,postnatal albumin,and critically ill scores in early HCA group and middle-late HCA group were lower than non-HCA group(P<0.05).There was no significant difference in sex,birth weight,1 min Apgar score among the groups(P>0.05).(5)The count of WBC and neutrophil percentage in early HCA group and middle-late HCA group were significantly higher than non-HCA group,The count of WBC in middle-late HCA group were significantly higher than early HCA group(P<0.05).Therewas no statistically significant difference in postnatal CRP value,invasive ventilation time,highest invasive ventilation FiO2、 total ventilation time in each group(P>0.05).(6)The incidence of anemia,PDA,PVL,RDS in early HCA group and middle-late HCA group were significantly higher than non-HCA group(P<0.05).the incidence of RSD BPD premature infants in the middle-late HCA group was greater than that in the non-HCA group and early HCA group,There is statistical significance amang three groups.(P <0.05),and the incidence of NEC in each group was not statistically significant(P>0.05).Conclusions:HCA is closely related to BPD in preterm infants.HCA increases the incidence of BPD.HCA stage is not related to the severity of BPD.Mother’s prenatal white blood cell count and prenatal C-reactive protein value increase may indicate placental inflammation to a certain extent.HCA significantly increases the incidence of BPD children with other diseases like anemia,patent ductus arteriosus,respiratory distress syndrome,periventricular leukomalacia.