Fetal inflammatory response and brain injury in preterm newborns / 国际儿科学杂志

The fetal inflammatory response to intrauterine infection plays a crucial role in the pathogenesis of preterm birth and preterm brain injury.The fetal inflammatory response is characterized by elevated levels of proinflammatory cytokines in the fetal circulation.The inflammation signal is likely transmitted across the blood-brain barrier and initiates a neuroinflammatory response and triggers damage in the developing brain.A better understanding of the fetal inflammatory response will help design interventions to improve neurodevelopmental outcomes after preterm birth.This review summarizes researches of fetal inflammatory response and brain injury in the preterm newborn.

Meta-analysis of the risk factors for intracranial hemorrhage in premature infants / 临床儿科杂志

Objective To evaluate the risk factors for intracranial hemorrhage in premature infants. Methods Cochrane Library, PubMed, ScienceDirect, Chinese Academic Literature Main Database, Chinese Science and Technology Periodi-cal Database, Wanfang Periodicals and Dissertation Database were searched for articles published from January 2000 to December 2012 on the risk factors of intracranial hemorrhage in premature infants, with retrospective retrieval and manual retrieval as supplement. RavMan5.2 provided by Cochrane was used for meta-analysis. Fixed-or random-effects models were selected according to the results of heterogeneity test. Results Nine studies were conifrmed to be eligible. Odds ratio (OR) and 95%conifdence interval (CI) of the risk factors were as follows:gestation age≤32 weeks (OR=3.29, 95%CI=2.76-3.91), birth weight≤1 500g (OR=2.68, 95% CI=2.24-3.20), maternal complications (OR=1.59, 95% CI=1.23-2.06), intrauterine distress or birth asphyxia (OR=2.42, 95% CI=2.06-2.84), mechanical ventilation (OR=3.23, 95% CI=2.55-4.09), metabolic acidosis (OR=2.88, 95%CI=2.04-4.05), use of high concentration of oxygen (OR=2.98, 95%CI=1.63-5.44), prenatal use of dexametha-sone (OR=0.69, 95%CI=0.55-0.86), respiratory distress syndrome (OR=1.57, 95%CI=1.04-2.39). Those differences were all statistically signiifcant. There was no difference in caesarean section (OR=0.99, 95%CI=0.84-1.17), multiparity (OR=1.05, 95%CI=0.79-1.40) and gender (OR=1.25, 95%CI=0.97-1.59). Conclusions The risk factors for intracranial hemorrhage in premature infants are gestation age≤32 weeks, birth weight≤1 500 g, maternal complications, intrauterine distress or birth asphyxia, mechanical ventilation, metabolic acidosis, use of high concentration of oxygen, respiratory distress syndrome, but prenatal use of dexamethasone can reduce the incidence of intracranial hemorrhage in premature infants.