Correlation of Histologic Chorioamnionitis with Ureaplasma species and Chronic Ventilator-Dependent Bronchopulmonary Dysplasia in Extremely Low Birth Weight Infants

학위논문 (석사)-- 서울대학교 대학원 : 의학과, 2015. 2. 김한석.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.Abstract i Contents iii List of tables and figures iv Introduction 2 Materials and Methods 4 Results 8 Discussion 14 References 19 Abstract in Korean 23Maste