[Histologic chorioamnionitis is associated with cerebral palsy]

The objective of this study was to determine the interaction between histologic chorioamnionitis and unexplained neonatal cerebral palsy among low-birth-weight infants.

105 preterm infants delivered under 1500 g between 2000-2004 were studied. The clinical data, the neonatal neuroimaging, the laboratory results finds and the histopathologic features of fetal parts (placenta, umbilical cord and membranes) were evaluated.

During the study period cerebral palsy were detected in 7.6% (8/105) of the newborns. The frequency of silent histologic chorioamnionitis was 39.7% (31 cases). The rate of caesarean section was 80.9% (72/89 deliveries), and elective operation was made in 51 cases (70.1%). In a logistic regression analysis controlling for confounding factors, compared with data on uninfected infants, histologic chorioamnionitis was significantly associated with risk of unexplained cerebral palsy (p = 0.006). There was also significant interaction between the maternal genital infections and chorioamnionitis (p = 0.024), and the maternal infections and positive smear of neonatal gastric aspirates (p = 0.033). There was no significant association between of intrapartum distress, the maternal genital infections, the prematurity and the maternal complications (hypertension, preeclampsia, diabetes mellitus, IUGR). Neither mechanic nor hypoxic ischaemic encephalopathy were demonstrated.

Intrauterine exposure to maternal infection was associated with a marked increase in risk for cerebral palsy in infants of birth weight less than 1500 g.