108985
论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
- 3.4 Breast Cancer (Dove Med Press)
- 3.2 Clin Epidemiol
- 2.6 Cancer Manag Res
- 2.9 Infect Drug Resist
- 3.7 Clin Interv Aging
- 5.1 Drug Des Dev Ther
- 3.1 Int J Chronic Obstr
- 6.6 Int J Nanomed
- 2.6 Int J Women's Health
- 2.9 Neuropsych Dis Treat
- 2.8 OncoTargets Ther
- 2.0 Patient Prefer Adher
- 2.2 Ther Clin Risk Manag
- 2.5 J Pain Res
- 3.0 Diabet Metab Synd Ob
- 3.2 Psychol Res Behav Ma
- 3.4 Nat Sci Sleep
- 1.8 Pharmgenomics Pers Med
- 2.0 Risk Manag Healthc Policy
- 4.1 J Inflamm Res
- 2.0 Int J Gen Med
- 3.4 J Hepatocell Carcinoma
- 3.0 J Asthma Allergy
- 2.2 Clin Cosmet Investig Dermatol
- 2.4 J Multidiscip Healthc
已发表论文
早产分娩时产前发热女性发生组织学绒毛膜羊膜炎的危险因素：一项回顾性队列研究
Authors Lin N, Shi Y, Xia Y, Yang Y, Hua R
Received 24 May 2025
Accepted for publication 14 October 2025
Published 23 October 2025 Volume 2025:17 Pages 3777—3788
DOI https://doi.org/10.2147/IJWH.S542606
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Matteo Frigerio
Nan Lin,1,2,* Yiru Shi,1,2,* Yuanqing Xia,1,2 Yunfan Yang,1,2 Renyi Hua1,2
1Department of Obstetrics, the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, People’s Republic of China; 2Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Renyi Hua, Email renyi3551_cn@me.com
Background and Objective: Histologic chorioamnionitis (HCA) complicates preterm birth and adversely affects neonatal and maternal outcomes; however, early recognition remains challenging. Here, we aimed to identify risk factors for HCA and assess its impact on pregnancy outcomes in preterm deliveries with prenatal fever.
Design: Retrospective cohort analysis.
Setting: Tertiary obstetrics and Gynecology Hospital in Shanghai, China.
Participants: A total of 220 women who delivered preterm (gestational age < 37 weeks) with prenatal fever between January 2018 and December 2020 were ultimately included in the study. This included an HCA group (101 cases) and control group (119 cases).
Main Outcome Measures: HCA diagnosis by placental pathology; neonatal outcomes.
Results: The incidence of congenital infection (27.66 vs 15.38%, P=0.029) and neonatal sepsis (8.89 vs 0.90%, P=0.017) was significantly greater in the HCA group than in the control group. Fever interval and PROM between 24 to 48 h (aOR=3.603, 95% CI 1.027~12.644) and > 48 h (aOR=6.201, 95% CI 1.729~22.238) were associated with HCA. A maternal WBC count ≥ 11× 109/L demonstrated a sensitivity of 80%, a specificity of 46%, a positive predictive value of 56.3%, and a negative predictive value of 73.3% for HCA prediction. A maternal white blood cell count ≥ 11× 109/L demonstrated optimal discriminatory power for HCA (AUC=0.667, 95% CI 0.569~0.738).
Conclusion: HCA significantly increases the risks of neonatal sepsis and congenital infection in preterm infants. A prolonged PPROM-fever interval (> 24 h) and a maternal WBC ≥ 11× 109/L are key predictive factors for the need for active obstetric intervention. This study provides evidence-based cutoff values for clinical decision-making in preterm pregnancies with fever, potentially improving maternal and neonatal outcomes through timely intervention.
Plain Language Summary: 1.The study identified clinically relevant risk factors, including the novel finding of an optimal WBC cutoff value (11× 109/L) for predicting histological chorioamnionitis, which could assist obstetricians in early clinical decision-making.The study performed multiple logistic regression analysis to control for potential confounders, providing robust evidence for the association between various maternal factors and histological chorioamnionitis.The single-center design limits the generalizability of our findings, as practices and patient populations may vary across different institutions and regions.The observational retrospective design prevents establishment of causal relationships and may introduce unmeasured confounding factors despite our statistical adjustments.
Keywords: histologic chorioamnionitis, prenatal fever, preterm birth, preterm premature rupture of membranes
1Department of Obstetrics, the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, People’s Republic of China; 2Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Renyi Hua, Email renyi3551_cn@me.com
Background and Objective: Histologic chorioamnionitis (HCA) complicates preterm birth and adversely affects neonatal and maternal outcomes; however, early recognition remains challenging. Here, we aimed to identify risk factors for HCA and assess its impact on pregnancy outcomes in preterm deliveries with prenatal fever.
Design: Retrospective cohort analysis.
Setting: Tertiary obstetrics and Gynecology Hospital in Shanghai, China.
Participants: A total of 220 women who delivered preterm (gestational age < 37 weeks) with prenatal fever between January 2018 and December 2020 were ultimately included in the study. This included an HCA group (101 cases) and control group (119 cases).
Main Outcome Measures: HCA diagnosis by placental pathology; neonatal outcomes.
Results: The incidence of congenital infection (27.66 vs 15.38%, P=0.029) and neonatal sepsis (8.89 vs 0.90%, P=0.017) was significantly greater in the HCA group than in the control group. Fever interval and PROM between 24 to 48 h (aOR=3.603, 95% CI 1.027~12.644) and > 48 h (aOR=6.201, 95% CI 1.729~22.238) were associated with HCA. A maternal WBC count ≥ 11× 109/L demonstrated a sensitivity of 80%, a specificity of 46%, a positive predictive value of 56.3%, and a negative predictive value of 73.3% for HCA prediction. A maternal white blood cell count ≥ 11× 109/L demonstrated optimal discriminatory power for HCA (AUC=0.667, 95% CI 0.569~0.738).
Conclusion: HCA significantly increases the risks of neonatal sepsis and congenital infection in preterm infants. A prolonged PPROM-fever interval (> 24 h) and a maternal WBC ≥ 11× 109/L are key predictive factors for the need for active obstetric intervention. This study provides evidence-based cutoff values for clinical decision-making in preterm pregnancies with fever, potentially improving maternal and neonatal outcomes through timely intervention.
Plain Language Summary: 1.The study identified clinically relevant risk factors, including the novel finding of an optimal WBC cutoff value (11× 109/L) for predicting histological chorioamnionitis, which could assist obstetricians in early clinical decision-making.The study performed multiple logistic regression analysis to control for potential confounders, providing robust evidence for the association between various maternal factors and histological chorioamnionitis.The single-center design limits the generalizability of our findings, as practices and patient populations may vary across different institutions and regions.The observational retrospective design prevents establishment of causal relationships and may introduce unmeasured confounding factors despite our statistical adjustments.
Keywords: histologic chorioamnionitis, prenatal fever, preterm birth, preterm premature rupture of membranes