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Chorioamnionitis and outcome in extremely preterm infants.

G Fung1, K Bawden, P Chow

  • 1Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia.

Annals of the Academy of Medicine, Singapore
|July 12, 2003
PubMed
Summary

Chorioamnionitis in extremely preterm infants is linked to a lower risk of respiratory distress syndrome (RDS) but a higher risk of chronic lung disease (CLD), cerebral palsy, and visual impairment.

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Area of Science:

  • Neonatalogy
  • Perinatal Medicine
  • Pediatric Neurology

Background:

  • Chorioamnionitis, an intrauterine infection, is a known risk factor for preterm birth.
  • It triggers a fetal inflammatory response with elevated cytokines, leading to abnormal lung maturation.
  • This condition is associated with reduced respiratory distress syndrome (RDS) but increased chronic lung disease (CLD) and cerebral injury.

Purpose of the Study:

  • To examine the relationship between chorioamnionitis and outcomes in extremely premature infants.
  • Investigated were rates of RDS, CLD, cerebral lesions, neurodevelopmental status, and mortality.

Main Methods:

  • A cohort of 388 infants born before 28 weeks gestation or weighing less than 1000g was studied.
  • Infants were divided into two groups: those with (Group 1) and without (Group 2) evidence of chorioamnionitis.

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  • Outcomes were compared between the two groups.

    • Main Results:

    • Chorioamnionitis was associated with an increased risk of extreme preterm delivery.
    • Infants with chorioamnionitis showed a trend towards higher rates of CLD and mortality.
    • Incidences of periventricular leukomalacia, retinopathy of prematurity, and necrotizing enterocolitis were similar between groups.

    Conclusions:

    • Extremely preterm infants exposed to chorioamnionitis had a decreased risk of RDS.
    • However, these infants demonstrated a trend towards increased CLD, mortality, cerebral palsy, and visual impairment.
    • Neurodevelopmental outcomes like developmental delay and hearing impairment showed no significant difference.