Association of chorioamnionitis and its duration with neonatal morbidity and mortality

Venkatesh, Kartik K.; Jackson, Wesley M.; Hughes, Brenna L.; Laughon, Mathew M.; Thorp, John M.; Stamilio, David M.

doi:10.1038/s41372-019-0322-0

Cited by 52 publications

(34 citation statements)

References 31 publications

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“…54 Maternal tachycardia may be the result of dehydration, the work of labour and, of course, critically but less commonly, underlying cardiorespiratory and metabolic/endocrine pathology. However, as chorioamnionitis is associated with an increased neonatal morbidity and mortality, 55 there is a low threshold to commence empirical broad-spectrum intravenous antibiotics, particularly during preterm labour at <34 weeks of gestation, as these neonates are at greatest risk of early-onset sepsis. 56…”

Section: Controversiesmentioning

confidence: 99%

Maternal sepsis update: current management and controversies

Greer

Shah

Johnson

2019

The Obstetric & Gynaecologis

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Sepsis is a leading cause of maternal morbidity and mortality, globally and in the UK. In pregnancy and the puerperium, women may be more susceptible to rapid deterioration of illness following an infection. Sepsis has a complex pathophysiology and the immunological and cardiovascular adaptations of normal pregnancy may have an adverse impact on the maternal response to infection. Furthermore, physiological changes of pregnancy, which mimic those of sepsis, often delay recognition and optimal management. 'Bedside' identification of pathogens and their antibiotic resistance patterns may help to improve clinical outcomes. Recent updates in sepsis management, areas of controversy and the importance of translational research and clinical trials for pregnancy and the puerperium are discussed. Learning objectivesTo highlight the difficulties of diagnosing sepsis in pregnancy. To highlight recent updates, new definitions and controversies of current sepsis management. To highlight the potential for research to develop novel biomarkers and therapeutic agents specific to the pregnant woman. Ethical issuesSepsis research involving new technologies differentially benefits high-income countries compared with low-/middle-income countries despite the greatest burden of maternal sepsis being in the latter. With the current rapid evolution of omic technology platforms, greater affordability will provide greater accessibility.

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Section: Controversiesmentioning

confidence: 99%

Maternal sepsis update: current management and controversies

Greer

Shah

Johnson

2019

The Obstetric & Gynaecologis

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“…(1) The importance of clinical diagnosis in the pregnant woman has been underlined by its association with fetal and maternal mortality if left untreated [2]. Studies have shown that chorioamnionitis was associated with an approximately 2-and 3.5-fold increased odds of neonatal adverse outcomes < 34 and > 34 weeks respectively regardless of chorioamnionitis duration [3].…”

Section: Introductionmentioning

confidence: 99%

Interaction of chorioamnionitis at term with maternal, fetal and obstetrical factors as predictors of neonatal mortality: a population-based cohort study

Zaki

Balayla

Beltempo

et al. 2020

BMC Pregnancy Childbirth

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Background: Chorioamnionitis is a frequent complication of pregnancy and is known to be associated with serious adverse post-natal outcomes including death. However, the assessment of fetal well-being in labor in the context of chorioamnionitis is often challenging because of fetal tachycardia. Identifying specific risk factors for adverse neonatal outcomes in the context of chorioamnionitis could therefore be of paramount importance. This study aimed to determine if maternal and fetal risk factors for increased neonatal mortality and early neonatal mortality are modified in the context of chorioamnionitis in term pregnancies. Methods: A retrospective population-based cohort study using the United States birth/infant death public file from 2011 to 2013 was performed, including all live births at 37 weeks gestation and beyond. Interaction between chorioamnionitis and maternal demographic variables as well as labor and delivery potential risk factors were analyzed for association with neonatal death (< 28 days) and early neonatal death (< 7 days) using multivariate logistic regressions. Results: Among 9,034,428 live births, the prevalence of chorioamionitis was 1.29% (95% CI 1.28-1.30%). The incidence of neonatal death and early neonatal death were 0.09 and 0.06% in the chorioamnionitis group versus 0.06 and 0.04% in the no chorioamnionitis group (p = 0.0003 and < 0.0001), respectively. Smoking was significantly associated with neonatal death and early neonatal death in the context of chorioamnionitis (OR 2.44,

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“…14 . This is particularly concerning for preterm deliveries, 40-70% of which may be associated with histologically confirmed chorioamnionitis and higher baseline rates of adverse neonatal outcomes 15,16 . This suggests that less stringent criteria for the diagnosis of chorioamnionitis should be used in preterm deliveries.…”

Section: Discussionmentioning

confidence: 99%

A Survey on Variation in Diagnosis and Treatment of Chorioamnionitis in Tertiary Centres in Canada

Charpentier

McDonald

Elwood

et al. 2022

Journal of Obstetrics and Gynaecology Canada

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Association of chorioamnionitis and its duration with neonatal morbidity and mortality

Cited by 52 publications

References 31 publications

Maternal sepsis update: current management and controversies

Maternal sepsis update: current management and controversies

Interaction of chorioamnionitis at term with maternal, fetal and obstetrical factors as predictors of neonatal mortality: a population-based cohort study

A Survey on Variation in Diagnosis and Treatment of Chorioamnionitis in Tertiary Centres in Canada

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