| Autor: |
Been, J V, Kramer, B W, Rours, I G, Kornelisse, R F, De Krijger, R R, Zimmermann, L J |
| Zdroj: |
Pediatric Research; November 2010, Vol. 68 Issue: 1, Number 1 Supplement 1 p231-232, 2p |
| Abstrakt: |
Background: Antenatal exposure to histological chorioamnionitis affects neonatal outcome. Early identification of affected infants could potentiate early intervention. However, in clinical practice the final results of placental pathology may take weeks.Methods: Placental pathology and relevant clinical data were obtained from consecutively born singleton infants (gestational age < 32 wks) in the Erasmus MC. Prediction models for histological chorioamnionitis (HC) and for HC with fetal involvement (FI) were constructed using clinical variables known at birth, in a backward logistic regression model. ROC curves were computed using model-derived predictives.Results: Of the 216 included infants 84 had HC, of whom 51 had FI. HC+FI was best predicted by a combination of low gestational age, clinical chorioamnionitis, PPROM, absence of preeclampsia and not being small for gestational age (Table 1; AUC(95%CI)=0.93(0.89-0.96), p<.001). HC was best predicted by the same model with addition of placental weight (Table 2; AUC(95%CI)=0.95(0.93-0.98); p<.001). At a set specificity of 90%, sensitivity of the model is 82% for HC+FI and 85% for HC.Conclusion: HC and HC+FI can be predicted fairly accurately by a simple set of clinical variables available at birth. External validation is required to confirm the usefulness of these models. This may potentiate early intervention to improve future outcome in affected infants. |
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