Document Detail


Maternal, neonatal, and placental features associated with diffuse chorioamniotic hemosiderosis, with special reference to neonatal morbidity and mortality.
MedLine Citation:
PMID:  15060230     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our purpose was to examine the significance of diffuse chorioamniotic hemosiderosis (DCH) on neonatal morbidity and mortality. METHODS: Using data from a retrospective case-control study, we analyzed 46 singleton placentas with DCH from infants who were delivered and/or admitted to the neonatal intensive care unit of Kanagawa Children's Medical Center during 1987-2001 and 92 control placentas without DCH from infants of comparable gestational age, birth weight, and duration. RESULTS: Mean and standard deviation of gestational age and infants' birth weight at delivery from the DCH group were 27 +/- 3 weeks and 939 +/- 342 g, respectively. Macroscopically, the placentas with DCH were more likely to show old peripheral blood clots (46% in the DCH group vs 8% in control group), subchorionic hematoma (20% vs 1%), and circumvallation (13% vs 1%). Histologically, amniotic necrosis was significantly more frequent in the DCH group (63% vs 24%). Of the obstetric factors, incidence of recurrent episodes of vaginal bleeding (70% vs 11%), oligohydramnios (59% vs 8%), and chronic abruption-oligohydramnios sequence (57% vs 5%) were significantly higher in the DCH group. Of the neonatal factors, persistent pulmonary hypertension of the newborn (29% vs 8%) and dry lung and/or pulmonary hypoplasia (20% vs 4%) were more common. However, respiratory distress syndrome was rare (15% vs 45%) in the DCH group. Neonatal death including stillbirth was increased in the DCH group but was not significant (24% vs 15%). Of infants who survived beyond day 28, chronic lung disease (CLD) was more frequent in the DCH group (51% vs 22%). The association of DCH, especially accompanied by amniotic necrosis, with CLD was still evident using likelihood ratio test. CONCLUSION: DCH is closely associated with preterm delivery, pulmonary hypertension of the newborn, and dry lung syndrome and is a significant risk factor for CLD.
Authors:
Makiko Ohyama; Yasufumi Itani; Michiko Yamanaka; Akiko Goto; Keisuke Kato; Rieko Ijiri; Yukichi Tanaka
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  113     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-02     Completed Date:  2004-05-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  800-5     Citation Subset:  AIM; IM    
Affiliation:
Division of Neonatology, Kanagawa Children's Medical Center, Yokohama City, Japan. neoohyama@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Abruptio Placentae / etiology
Amnion
Case-Control Studies
Chorion / chemistry
Female
Hemosiderosis / complications*,  pathology*
Humans
Infant Mortality
Infant, Newborn
Infant, Premature*
Iron / analysis
Likelihood Functions
Lung / abnormalities
Lung Diseases
Oligohydramnios / etiology
Persistent Fetal Circulation Syndrome
Placenta / pathology*
Pregnancy
Pregnancy Outcome
Respiratory Distress Syndrome, Newborn
Retrospective Studies
Uterine Hemorrhage / etiology
Chemical
Reg. No./Substance:
7439-89-6/Iron

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