Objective To investigate the impact of histological chorioamnioitis (HCA) on complications and neurodevelopment in premature infants at 1 year of age,in order to provide reference for perinatal management and early intervention. Methods A total of 342 premature infants born at Jiangyou People's Hospital from January 2017 to December 2022 were selected as study subjects.Then the participants were divided into a control group(n=214),a mild HCA group(n=38),a moderate HCA group(n=56),and a severe HCA group(n=34) based on their exposure to HCA and severity.The complications of premature infants and the neurological development status at corrected gestational age of 1 year were compared among the four groups,and the effects of different degrees of HCA on the neurological development of premature infants were analyzed. Results There were statistically significant differences in gestational age(F=6.546),birth weight(F=14.780),the rates of cesarean section(χ2=5.427) and premature rupture of membranes (χ2 =6.215)among the four groups of premature infants (P＜0.05).In terms of complications,there was significant difference in the incidence of early onset sepsis (EOS) and >grade Ⅱ intraventricular hemorrhage (IVH) among four groups of premature infants (χ2=1.273,2.457,P<0.05).There were significant differences in gross and fine motor development at 1 year of corrected gestational age among four groups of premature infants (P<0.05).Further pairwise comparison between groups showed that compared with the control group,the severe HCA group had delayed adaptability,gross and fine motor development (P<0.05),while the moderate HCA group had delayed gross and fine motor development (P<0.05);compared with the mild HCA group,the severe HCA group lagged behind in adaptability and gross motor development (P<0.05),moderate HCA group lagged behind in gross motor development (P<0.05);compared with moderate HCA group,severe HCA group had lower score of gross motor (P<0.05).Multivariate Logistic regression analysis showed that compared with the control group,the severe HCA group had a relatively higher risk in adaptability (OR=1.559,95%CI: 1.084 - 2.869) and gross motor development delay(OR=2.958,95%CI: 1.824 - 4.662),while the moderate HCA group had an increased risk of gross motor development delay(OR=1.428,95%CI: 1.014 - 3.752,P＜0.05). Conclusion HCA is associated with the occurrence of EOS and IVH above grade Ⅱ in premature infants,and may increase the risk of neurodevelopmental abnormalities in premature infants at 1 year old,especially moderate to severe HCA.
Key words
histological chorioamnioitis /
complications /
neurodevelopment /
preterm
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