초극소저체중출생아에서 조직학적 융모양막염 및 유레아플라즈마와 만성기계환기 의존적 기관지폐이형성증의 연관성

Abstract

Purpose: Histologic chorioamnionitis (HCAM) and Ureaplasma have been considered independent risk factors for bronchopulmonary dysplasia (BPD). This study tested the hypothesis that extremely low birth weight (ELBW) infants with coexisting HCAM and Ureaplasma are at an increased risk for more severe BPD necessitating chronic ventilator support. Materials and Methods: A retrospective cohort study was performed. Pathologic examination of the placenta was carried out, and gastric fluids of infants were analyzed with real-time PCR and culture to detect Ureaplasma at birth. The demographic and clinical characteristics were compared according to the presence of HCAM and Ureaplasma (HCAM+U+, HCAM+U-, HCAM-U+, HCAM-U-), and the risk factors for chronic ventilator-dependent BPD were searched. Results: Twenty (19.6%) of 102 infants were in the HCAM+U+ group. Although there were no significant differences in the clinical characteristics including the incidence of BPD, the rate of chronic ventilator dependency was higher in the HCAM+U+ group compared with the other groups: HCAM+U+ (27.8%), HCAM+U- (0%), HCAM-U+ (0%), and HCAM-U- (2.3%) (p=0.005). In the multivariate logistic regression analysis, coexistence of HCAM and Ureaplasma was independently a significant risk factor for chronic ventilator dependent BPD (odds ratio 14.5, 95% confidence interval 1.1 – 188.9) Conclusion: Coexistence of HCAM and Ureaplasma is a significant risk factor for chronic ventilator-dependent BPD in ELBW infants.