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Licensed Unlicensed Requires Authentication Published by De Gruyter June 26, 2017

The combined exposure to intra-amniotic inflammation and neonatal respiratory distress syndrome increases the risk of intraventricular hemorrhage in preterm neonates

  • Kyung Joon Oh , Jee Yoon Park , JoonHo Lee , Joon-Seok Hong EMAIL logo , Roberto Romero and Bo Hyun Yoon

Abstract

Objective:

To evaluate the impact of combined exposure to intra-amniotic inflammation and neonatal respiratory distress syndrome (RDS) on the development of intraventricular hemorrhage (IVH) in preterm neonates.

Methods:

This retrospective cohort study includes 207 consecutive preterm births (24.0–33.0 weeks of gestation). Intra-amniotic inflammation was defined as an amniotic fluid matrix metalloproteinase-8 concentration >23 ng/mL. According to McMenamin’s classification, IVH was defined as grade II or higher when detected by neurosonography within the first weeks of life.

Results:

(1) IVH was diagnosed in 6.8% (14/207) of neonates in the study population; (2) IVH was frequent among newborns exposed to intra-amniotic inflammation when followed by postnatal RDS [33% (6/18)]. The frequency of IVH was 7% (8/115) among neonates exposed to either of these conditions – intra-amniotic inflammation or RDS – and 0% (0/64) among those who were not exposed to these conditions; and (3) Neonates exposed to intra-amniotic inflammation and postnatal RDS had a significantly higher risk of IVH than those with only intra-amniotic inflammation [odds ratio (OR) 4.6, 95% confidence interval (CI) 1.1–19.3] and those with RDS alone (OR 5.6, 95% CI 1.0–30.9), after adjusting for gestational age.

Conclusion:

The combined exposure to intra-amniotic inflammation and postnatal RDS markedly increased the risk of IVH in preterm neonates.


Corresponding author: Joon-Seok Hong, MD, PhD, Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, 13620, Korea, Phone: +82-31-787-7256, Fax: +82-31-787-4054

Acknowledgments

National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (No. 2011-0000195), and in part by Seoul National University Bundang Hospital Research Fund (No. 11-2011-018). The work of Dr. Romero was supported by the Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS) and, in part, with Federal funds from NICHD/NIH/DHHS under Contract No. HHSN275201300006C. Dr. Romero has contributed to this work as part of his official duties as an employee of the United States Federal Government.

Author’s statement

  1. Conflict of interest: Authors state no conflict of interest.

  2. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  3. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

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Received: 2016-11-1
Accepted: 2017-1-12
Published Online: 2017-6-26
Published in Print: 2018-1-26

©2018 Walter de Gruyter GmbH, Berlin/Boston

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