Advisory Committee Chair
Marguerite R Irvin
Advisory Committee Members
Date of Award
Degree Name by School
Master of Science (MS) School of Public Health
Background. Acute placental inflammation (API) has been associated with various adverse outcomes in preterm infants. However, little is known about how API affects their body composition and growth outcomes. This study aims to examine the association between API and growth outcomes in preterm infants. Methods. We conducted a retrospective cohort study of mother-infant dyads born < 326/7 weeks of gestation with fat mass (FM) accretion measured using air displacement plethysmography at term-equivalent age. API severity including maternal inflammatory response (MIR) and fetal inflammatory response (FIR) was staged according to criteria by Society for Pediatric Pathology based on placental pathology reports. We examined the differences in characteristics of mother-infant dyads by API severity using ANOVA or the Kruskall-Wallis test. The association between API severity and growth outcomes was analyzed using linear regression models and adjusted for statistically significant confounders. Mediation analyses were used to study the direct and indirect association of API and growth outcomes via gestational age. Results. Among 375 mother-infant dyads analyzed, 104 (28%) dyads had MIR. FIR was found in 82% of dyads with MIR. Adjusted models indicated that API severity progression was positively associated with FM accretion. Gestational age partially (49%) iv mediated the association between API severity and FM z score (indirect effect: b=0.12, 95% CI: 0.05-0.19; direct effect: b=0.12, 95% CI: 0.01-0.25). Conclusions. API severity is associated with growth outcomes and helps to accurately predict body composition in preterm infants.
Gunawan, Emily, "Acute Placental Inflammation and Growth Outcomes in Preterm Infants" (2023). All ETDs from UAB. 457.