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Abstract：
The objective of this study was to assess the relationship of ACS with neonatal outcomes among very preterm infants born to mothers with clinical chorioamnionitis in China. This was a multicenter retrospective cohort study. Study participants included infants born at <32 weeks\' gestation with clinical chorioamnionitis and registered in the Chinese Neonatal Network from 1 January 2019 to 31 December 2020. Infants were divided into two groups: any amount of ACS or no administration of ACS. Multivariable generalized linear models using generalized estimating equations were used to assess the association between ACS and neonatal outcomes among the study population. We identified 2193 infants eligible for this study; 1966 (89.6%) infants had received ACS therapy, and 227 (10.4%) had not received any ACS therapy. Among very preterm infants born to mothers with clinical chorioamnionitis, any ACS usage was significantly associated with decreased risks of early death (aRR 0.56, 95% CI 0.32, 0.99) and severe ROP (aRR 0.51, 95% CI 0.28, 0.93) after adjustment for maternal hypertension, gestational age at birth, Caesarean section, being inborn, and administration of systemic antibiotics to the mother within 24 h before birth. In addition, out of the 2193 infants, the placentas of 1931 infants underwent pathological examination with recorded results. Subsequently, 1490 of these cases (77.2%) were diagnosed with histological chorioamnionitis. In 1490 cases of histologic chorioamnionitis, any ACS usage was significantly related to decreased risks of overall mortality (aRR 0.52, 95% CI 0.31, 0.87), severe ROP (aRR 0.47, 95% CI 0.25, 0.97), and respiratory distress syndrome (aRR 0.52, 95% CI 0.31, 0.87). We concluded that any ACS was associated with reduced risks for neonatal early death and severe ROP among very preterm infants born to mothers with clinical chorioamnionitis.
摘要：
这项研究的目的是评估在中国患有临床绒毛膜羊膜炎的母亲所生的极早产儿中ACS与新生儿结局的关系。这是一项多中心回顾性队列研究。研究参与者包括出生在妊娠<32周的临床绒毛膜羊膜炎的婴儿，并在2019年1月1日至2020年12月31日在中国新生儿网络登记。婴儿分为两组：任何量的ACS或不施用ACS。使用广义估计方程的多变量广义线性模型用于评估研究人群中ACS与新生儿结局之间的关联。我们确定了2193名符合本研究条件的婴儿；1966名（89.6％）婴儿接受了ACS治疗，227例(10.4%)未接受任何ACS治疗.在患有临床绒毛膜羊膜炎的母亲所生的早产婴儿中，任何ACS的使用与早期死亡(aRR0.56,95%CI0.32,0.99)和严重ROP(aRR0.51,95%CI0.28,0.93)的风险降低显著相关,出生时的胎龄，剖腹产,与生俱来，并在出生前24小时内向母亲施用全身性抗生素。此外,在2193名婴儿中，1931名婴儿的胎盘接受了病理检查并记录了结果.随后，这些病例中有1490例（77.2％）被诊断为组织学绒毛膜羊膜炎。在1490例组织学绒毛膜羊膜炎中，任何ACS的使用都与总死亡率风险降低显著相关(RR0.52,95%CI0.31,0.87),严重ROP（ARR0.47，95%CI0.25，0.97），和呼吸窘迫综合征（RR0.52，95%CI0.31，0.87）。我们得出的结论是，在患有临床绒毛膜羊膜炎的母亲所生的极早产儿中，任何ACS都与新生儿早期死亡和严重ROP的风险降低有关。
