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KMID : 1101620170280040119
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Perinatology
2017 Volume.28 No. 4 p.119 ~ p.126
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The Influence of Pregnancy Disorders Causing Preterm Delivery on In-Hospital Outcomes in Preterm Infants at Less than 32 Weeks of Gestation
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Shin Jeong-Min
Lee Jin-A
Yun Hye-Ri
Oh So-Hee
Sohn Jin-A
Shin Seung-Han
Choi Chang-Won
Kim Ee-Kyung
Kim Han-Suk
Kim Byeong-Il
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Abstract
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Objective: We assessed the influence of small for gestational age (GA) with placental disorders (SGA-P) and histologic chorioamnionitis (HCA) on the in-hospital outcomes of preterm infants.
Methods: Preterm infants with a GA <32 weeks born at Seoul National University Hospital between 2007 and 2014 were included and divided into 4 groups according to the presence of SGA-P and HCA: group 1, SGA-P only; group 2, HCA only; group 3, both SGA-P and HCA; and group 4, no SGA-P or HCA. Multivariate logistic regression was done to compare neonatal outcomes including death, moderate to severe bronchopulmonary dysplasia (BPD) or death, patent ductus arteriosus with treatment, sepsis, necrotizing enterocolitis ≥stage 2b, and intraventricular hemorrhage ≥grade 3.
Results: A total of 572 infants were included. There were 77 patients (13.5%) in group 1, 226 patients (39.5%) in group 2, and 24 patients (4.2%) in group 3. After adjusting for GA, cesarean section, 5 minute Apgar score, multiple pregnancy, premature rupture of membrane before 18 hours prior to delivery, and preeclampsia, group 1 showed higher risks of mortality (adjusted odds ratio [aOR] 3.15, 95% confidence interval [CI] 1.13?8.80), moderate to severe BPD or death (aOR 9.12, 95% CI 3.98?20.90), sepsis (aOR 2.12, CI 1.01?4.46), and pulmonary hypertension (aOR 3.26, 95% CI 1.15?9.22) compared with group 4. There were no significant differences in mortality and in-hospital outcomes between groups 2 and 4 or between groups 3 and 4.
Conclusion: Close monitoring and early intervention are suggested in SGA-P infants.
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KEYWORD
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Preterm infants, Placenta disorders, Fetal growth retardation, Chorioamnionitis, Patient outcome assessment
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