American Journal of Obstetrics and Gynecology
ResearchObstetricsHistologic chorioamnionitis, fetal involvement, and antenatal steroids: effects on neonatal outcome in preterm infants
Section snippets
Design
This was a prospective, observational, nontherapeutic study with the aim to examine the association of histologic chorioamnionitis in early preterm delivery with neonatal outcome. Pregnant women, who delivered between May 2001–February 2003 in the Erasmus University Medical Center–Sophia Children's Hospital in Rotterdam, The Netherlands, at a gestational age of 32.0 weeks or less, were eligible for the study. Routine health care workers (residents, research-nursing staff, and neonatologists)
Maternal and delivery characteristics
Three hundred one preterm infants were included in the study. Histologic chorioamnionitis was present in 121 of these (40.2%), 68 (56.2%) of whom had signs of fetal involvement. Of the latter, all but 4 had inflammatory signs of both the fetal and maternal compartment. Maternal and delivery characteristics for the groups are shown in Table 1.
Both chorioamnionitis groups had lower gestational age and significantly higher rates of clinical chorioamnionitis and preterm premature rupture of
Comment
In this prospective cohort of preterm infants, chorioamnionitis with fetal involvement was associated with increased incidences of IVH, NEC, and neonatal mortality in univariable analyses. However, none of these associations remained after multivariable adjustment. Conversely, chorioamnionitis without fetal involvement was independently associated with a lower severe RDS risk, whereas the effect of chorioamnionitis with fetal involvement on the incidence of severe RDS was gestational-age
Acknowledgments
We thank F. Jonkers, P. van Felius, and E. Oschatz-Overbosch for their help in data collection and database design.
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Cited by (0)
Reprints not available from the authors.
This study was supported in part by the Revolving Fund, Erasmus University Medical Center, Rotterdam, The Netherlands. J.V.B. is supported by a Profileringsfonds Grant from the Maastricht University Medical Center.
The first 2 authors contributed equally to the study and article.
Cite this article as: Been JV, Rours IGIJG, Kornelisse RF, et al. Histologic chorioamnionitis, fetal involvement, and antenatal steroids: effects on neonatal outcome in preterm infants. Am J Obstet Gynecol 2009;201:587.e1-8.