Early postnatal skin colour changes in term newborns with subclinical histological chorioamnionitis

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• 作者：Claudio De Felice (A1)
  Paola Vacca (A2)
  Antonio Del Vecchio (A2)
  Mario Criscuolo (A3)
  Antonia Lozupone (A3)
  Giuseppe Latini (A2) (A4)
  
• 关键词：Apgar score ; Chorioamnionitis/diagnosis ; Colourimetry ; Infant ; Newborn ; Placenta diseases ; Skin
• 刊名：European Journal of Pediatrics
• 出版年：2004
• 出版时间：September 2004
• 年：2004
• 卷：163
• 期：9
• 页码：550-554
• 全文大小：188KB
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• 作者单位：Claudio De Felice (A1)
  Paola Vacca (A2)
  Antonio Del Vecchio (A2)
  Mario Criscuolo (A3)
  Antonia Lozupone (A3)
  Giuseppe Latini (A2) (A4)
  
  A1. Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy
  A2. Division of Neonatology, Perrino Hospital, Brindisi, Italy
  A3. Pathology Unit, Perrino Hospital, Brindisi, Italy
  A4. Clinical Physiology Institute (IFC-CNR), National Research Council of Italy, Lecce Section, s.s. 7 per Mesagne, 72100, Brindisi, Italy
  

文摘

Chorioamnionitis, a known risk factor for fetal and neonatal morbidity both in preterm and term newborns, is often subclinical. Earlier observations have linked skin colourimetry to neonatal illness severity and adverse neonatal outcome. Here, we tested the hypothesis that subclinical histological chorioamnionitis is associated with early postnatal skin colour changes in term newborns. Skin colourimetry on ten body sites (forehead, cheek, forearm, palm, upper chest, abdomen, back, buttock, leg, and sole) was examined in 45 term infants with subclinical histological chorioamnionitis and 45 sex- and gestational age-matched controls, using a tristimulus portable colourimeter at 1, 5 and 10?min after birth. Infants with subclinical histological chorioamnionitis showed statistically significant early postnatal skin colourimetric differences, in nine and seven out of the ten body sites examined as compared to control newborns at 1?min (P?.0092), 5?min (P?.0081) and 10?min (P?.0056) from birth, respectively. Skin colourimetry changes were associated with lower 1?min Apgar scores (P<0.0001), cord blood pH (P<0.0001), PaO2 (P<0.0001), and base excess (P<0.0001) values, together with higher cord blood PaCO2 (P=0.0001), NICU admissions (P=0.00076), endotracheal intubation in the delivery room (P=0.012), Neonatal Acute Physiology-Perinatal Extension (P<0.0001) and Neonatal Therapeutic Intervention Scoring System (P<0.0001) scores than the chorioamnionitis-negative infants. Conclusion:these findings, compatible with early peripheral microcirculatory changes, indicate skin vasoconstriction as an early neonatal manifestation of subclinical chorioamnionitis.