Clinical Chorioamnionitis and the Prognosis for Very Low Birth Weight Infants

Alexander, J.; Gilstrap, Larry C.; Cox, Susan M.; McIntire, Donald; Leveno, Kenneth J.

doi:10.1016/s0029-7844(98)00056-8

Cited by 145 publications

(53 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An almost universal finding in most studies is the increased risk of EONS, both in clinical and histological chorioamnionitis [6,10,16,24,25,26]. In our study the incidence of EONS was significantly higher among infants exposed to maternal clinical chorioamnionitis, and this association persisted after adjusting for GA, birth weight, and all other confounders.…”

Section: Discussionsupporting

confidence: 67%

“…While clinical chorioamnionitis has been considered an important risk factor for RDS [10], Watterberg et al [4] showed that histological chorioamnionitis can stimulate lung maturation, reducing the incidence of acute RDS but increasing lung susceptibility to postnatal damage when exposed to other potential noxious factors. An important issue to consider when referring to this morbidity is the effect of antenatal steroid administration [11] that, in fact, was not widely used when the above-mentioned studies were conducted.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, severe IVH and PVL were more frequent in exposed infants, but the multivariate analysis showed no modifications in the risk. Again, the results in the literature are controversial [10,19,20]. However, the meta-analysis by Wu and Colford [21] showed that clinical chorioamnionitis increased the risk of cystic PVL and cerebral palsy.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of Very-Low-Birth-Weight Infants Exposed to Maternal Clinical Chorioamnionitis: A Multicentre Study

Rodrigo

Henríquez²,

Aloy³

et al. 2014

Neonatology

View full text Add to dashboard Cite

Background: Chorioamnionitis is a recognized risk factor of preterm delivery; however, controversy still persists concerning the relationship between maternal inflammation and neonatal morbidity and mortality. Objective: To determine the incidence of clinical chorioamnionitis and its relationship to morbidity and mortality among very-low-birth-weight (VLBW) infants. Methods: This was a retrospective analysis of prospectively collected data of VLBW neonates ≤32 weeks' gestational age (GA) admitted to collaborating units in the Spanish SEN1500 Network between January 2008 and December 2011. Clinical chorioamnionitis was defined by obstetricians based on clinical findings, and neonatal outcomes were compared between exposed and non-exposed infants by multivariate logistic regression analysis. Results: During the study period, 11,464 VLBW newborns were admitted to our units and 10,026 were ≤32 weeks' GA. Among them, 8,330 (83.1%) had complete data and were included. Of these, 1,480 (17.8%) were exposed to maternal clinical chorioamnionitis. The incidence was higher at lower GA and, after adjusting for confounding factors, exposed infants had higher risks of early-onset neonatal sepsis (EONS) (10.0 vs. 2.8%; aOR 3.102; 95% CI 2.306-4.173; p < 0.001) and necrotizing enterocolitis (NEC) (11.2 vs. 7.7%; aOR 1.300; 95% CI 1.021-1.655; p < 0.033), but lower risks of patent ductus arteriosus (PDA) (43.2 vs. 34.9%; aOR 0.831; 95% CI 0.711-0.971; p < 0.02) and late-onset bacterial sepsis (LONS) (36.6 vs. 32.5%; aOR 0.849; 95% CI 0.729-0.989; p < 0.035). There were no differences in mortality between the groups. Conclusions: The incidence of maternal clinical chorioamnionitis is inversely related to GA at delivery, and in VLBW infants ≤32 weeks' GA it is associated with higher risks of EONS and NEC, but lower risks of PDA and LONS. We did not found differences in survival.

show abstract

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of Very-Low-Birth-Weight Infants Exposed to Maternal Clinical Chorioamnionitis: A Multicentre Study

Rodrigo

Henríquez²,

Aloy³

et al. 2014

Neonatology

View full text Add to dashboard Cite

show abstract

“…The risk of systemic fetal inflammation and chorioamnionitis is inversely related to gestational age [17,18]. We present a retrospective clinical study analyzing serum IL-6, coagulation profile and development of IVH in a cohort of preterm infants born with 23 0/7 to 27 6/7 weeks of gestational age.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies on preterm infants demonstrated an association of histopathologically confirmed chorioamnionitis and funisitis with the development of IVH [17,18,19,20,21]. Vergani et al [19] even reported a dose-dependent relationship between severity of acute placental inflammatory lesions and the severity of IVH.…”

Section: Discussionmentioning

confidence: 99%

Elevated Interleukin-6 Concentration and Alterations of the Coagulation System Are Associated with the Development of Intraventricular Hemorrhage in Extremely Preterm Infants

Poralla¹,

Hertfelder

Oldenburg

et al. 2012

Neonatology

View full text Add to dashboard Cite

Background: Pathogenesis of intraventricular hemorrhage (IVH) in premature infants is multifactorial. Little is known about the influence of pro-inflammatory cytokine activation on the coagulation system in extremely preterm infants and its impact on the development of IVH. Objective: To determine the interaction between serum interleukin-6 (IL-6) and the coagulation system in preterm infants predisposed to the development of IVH. Methods: Vitamin K-dependent coagulation factors were examined retrospectively in 132 extremely preterm infants prior to vitamin K administration at the first day of life. Patients were grouped according to the occurrence of IVH and serum concentration of IL-6 >/<100 pg/ml. Results: Occurrence of IVH was associated with clinical diagnosis of chorioamnionitis, low gestational age, high CRIB score, air leak, catecholamine treatment, low initial hematocrit and increased serum concentration of IL-6. Infants developing IVH showed a diminished coagulation profile. Multivariable logistic regression analysis revealed decreased activity of coagulation factor VII, development of pneumothorax and low hematocrit as independent risk factors for the development of IVH. An increased IL-6 serum concentration was associated with a significantly decreased activity of coagulation factor VII and increased levels of fibrinogen. Conclusions: The association of elevated IL-6 levels with alterations of the coagulation profile and development of IVH found in our study supports the assumption of a close pathophysiological relation between inflammation and IVH.

show abstract

Maternal Antibiotics and Decreased Periventricular Leukomalacia in Very Low-Birth-Weight Infants

Paul¹,

Coleman²,

Leef³

et al. 2003

Arch Pediatr Adolesc Med

View full text Add to dashboard Cite

show abstract

Clinical Chorioamnionitis and the Prognosis for Very Low Birth Weight Infants

Abstract: Our results suggest a link between clinical chorioamnionitis and several indices of neonatal morbidity in the very low birth weight infant. Chorioamnionitis appears to make the very low birth weight infant particularly vulnerable to neurologic damage.

Cited by 145 publications

References 12 publications

Outcomes of Very-Low-Birth-Weight Infants Exposed to Maternal Clinical Chorioamnionitis: A Multicentre Study

Outcomes of Very-Low-Birth-Weight Infants Exposed to Maternal Clinical Chorioamnionitis: A Multicentre Study

Elevated Interleukin-6 Concentration and Alterations of the Coagulation System Are Associated with the Development of Intraventricular Hemorrhage in Extremely Preterm Infants

Maternal Antibiotics and Decreased Periventricular Leukomalacia in Very Low-Birth-Weight Infants

Contact Info

Product

Resources

About