Correlated Factors Of Intrauterine Infection And Neonatal Patent Ductus Arteriosus

ObjectiveTo explore the relationship between intrauterine infection and PDA,for the medical staff to provide a reference for the development of prevention and control measures of PDA.MethodsA retrospective case-control study was conducted on the preterm infants who were delivered and hospitalized in the first Bethune hospital of Jilin univesity from January 2015 to August 2016.Clinical characteristics and placental histological results were collected from 168 preterm infants who preterm birth less than 34 weeks gestation.According to placental histological,the subjects were divided into 2 groups,group 1 with 49 cases of histological chorioamnionitis(HCA),group 2 with 119 cases of control group(no-HCA).Taking of samples compared between 113/168 who with a Hs-PDA was defined by echocardiographic,and 55/168 who without a Hs-PDA was defined by echocardiographic,for identifying their risk factors and complications.Data were analyzed with a simple and logistic regression model.ResultIn the HCA group,Maternal factors analysis: Intrauterine infection was more frequently associated with the incidence of premature rupture of membranes(p=0.049),abnormal amniotic fluid(p=0.046)and amniotic fluid to cultivate positive(p=0.023),prenatal antibiotics application time(p=0.039),and maternal CRP(p=0.000)compared with the control group.Neonatal factors analysis: the gestational age of HCA group was lower than the control group(p=0.015),and white blood cell count(p=0.003)and neutrophil count(p=0.013)is higher in the control group.The incidence of patent ductus arteriosus(p=0.016),intraventricular hemorrhage(p=0.033),early onset infectious diseases(p=0.036),and necroizing enterocolitis indence(p=0.037)in No-HCA group was significantly lower than that in the HCAgroup.In the Hs-PDA group.Univariate analysis showed that the incidence of maternal inflammation response positive(p=0.025),the incidence of respiratory distress syndrome(p=0.025),the incidence of intubation in the delivery room(p=0.043)and low platelet count within 24 hours(p=0.007)after birth were the risk factors of the Hs-PDA.Conditional Logistic regression analysis suggested maternal inflammation response positive(OR=3.426)and low platelet count within 24 hours after birth(OR=0.992)were independent risk factors for the incidence of Hs-PDA.Conclusion(1)The intrauterine inflammation response definitely affect neonatal outcome of premature newborns.HCA increased the incidence of PDA,NEC,IVH and early onset infectious diseases,premature rupture of membranes,abnormal amniotic fluid and amniotic fluid to cultivate positive.(2)The value of prenatal CRP,the first routine blood leukocytes and granulocyte percentage in predicting intrauterine infection infants with HCA is good.(3)Maternal inflammation response positives,the incidence of NRDS,the incidence of the intubation in the delivery room and low platelet count within 24 hours after birth were the risk factors of Hs-PDA.(4)Maternal inflammation response positives and low platelet count within 24 hours after birth were independent risk factors of Hs-PDA.