Effect of Chorioamnionitis on Platelet Activation and Placental Vessel Among Preterm Infants by Wnt-Flt1 Signal Pathway

Study Overview
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Brief Summary
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Objective:The purpose of this study was to explore the effect and mechanism of maternal chorioamnionitis on placental microvasculature and platelet activation among preterm infants by activating Wnt-Flt1 signal pathway . Methods:With clinical randomized controlled trial (RCT), the cases were matched with 1:1 according to gestational age and divided into 2 groups according to the placental pathology result: chorioamnionitis group and control group. (1) To observe the platelet parameter, birth weight, thrombrocytopenia and hemorrhage complication, such as intracranial hemorrhage, retinal hemorrhage, pulmonary hemorrhage and gastrointestinal hemorrhage. (2) To observe the miscrovascular density (MVD) in placenta, platelet activating factor (CD62p,CD63) and thrombopotetin (TPO) in preterrn infants.The placental MVD was assessed by immunohistochemical method. The platelet activating factors were detected by flow cytometry. TPO was detected by ELISA. (3) To observe Wnt5a, Flt1 and VEGF in placenta and fetal circulation.The measurement data were analyzed by pair t test and conditional logistic regression. Pearson correlation analysis was used for relationship.

Detailed Description
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The exclusive criteria included :(1) born to mother with no any other maternal complications; (2) no congenital abnormalities and neonatal asphyxia; (3) died or discharged within 72 hours.

Official Title
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Clinical Research: Effect of Chorioamnionitis on Platelet Activation and Placental Vessel Among Preterm Infants by Wnt-Flt1 Signal Pathway

Conditions
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Chorioamnionitis, Placenta Diseases, Thrombocytopenia, Preterm Infant

Intervention / Treatment
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* Other: chorioamnionitis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: gestational age<37weeks admitted to the NICU at Guangdong Women and Children Hospital, with a date of birth from June 2016 to December 2016 whose mothers were diagnosed chorioamnionitis by placental histopathology Exclusion Criteria: born to mother with no any other maternal complications no congenital abnormalities and neonatal asphyxia; died or discharged within 72 hours.

Ages Eligible for Study
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Minimum Age: 1 Hour

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Chorioamnionitis Group<br>preterm infants were born to mothers with chorioamnionitis | Other: chorioamnionitis<br>* It is a observation research. We didn't intervene anything. The chorioamnionitis groups included the infants whose mothers were diagnosed chorioamnionitis by placental histopathology.<br>|
| Control Group<br>preterm infants were born to mothers without chorioamnionitis | Other: chorioamnionitis<br>* It is a observation research. We didn't intervene anything. The chorioamnionitis groups included the infants whose mothers were diagnosed chorioamnionitis by placental histopathology.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Placental Microvascular Density(%) | Placental Microvascular Density (by placental histopathology) | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence Hemorrhage Disease (%) | intraventricular hemorrhage (IVH), retinal hemorrhage, pulmonary hemorrhage and gastrointestinal hemorrhage | through study completion, an average of half year | 
| Wnt5a in Placenta(IOD) | by placental histopathology | 24 hours | 
| mean platelet volume(MPV) | MPV (Fl) | 24 hours | 
| platelet distribution width(PDW) | PDW (%) | 24 hours | 
| Platelet counts (PLT) | PLT (10^9/L) | 24 hours | 
| Thrombopoietin (cord blood) | TPO(ng/ml) | 24 hours | 
| Platelets Activation Factors in cord blood | CD62p(%) | 24 hours | 
| Flt1 in Placenta(IOD) | by placental histopathology | 24 hours | 
| VEGF in Placenta(IOD) | by placental histopathology | 24 hours | 
| Wnt5 in infants (ng/ml) | test them by Elisa from cord blood | 24 hours | 
| Flt1 in infants (ng/ml) | test them by Elisa from cord blood | 24 hours | 
| VEGF in infants (ng/ml) | test them by Elisa from cord blood | 24 hours |