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Chorioamnionitis: important risk factor or innocent bystander for neonatal outcome?
Wolfgang Thomas1, Christian P Speer
1University Children's Hospital Würzburg, Würzburg, Germany. thomas_w@kinderklinik.uni-wuerzburg.de
Neonatology
|October 1, 2010
Summary
Chorioamnionitis significantly increases the risk of preterm birth and associated infant complications. While advances in neonatal care lessen its impact, it still poses risks like respiratory distress and brain injury.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Perinatal Medicine
Background:
- Chorioamnionitis is a primary risk factor for spontaneous preterm birth, leading to significant neonatal mortality and morbidity.
- Assessing the gestation-independent impact of chorioamnionitis on neonatal outcomes is challenging, especially with improved neonatal care.
- Prenatal inflammation/infection is a known risk factor for neonatal sepsis.
Purpose of the Study:
- To evaluate the multifaceted impact of chorioamnionitis on neonatal outcomes.
- To clarify the association between chorioamnionitis and specific neonatal morbidities, including respiratory distress, bronchopulmonary dysplasia, and neurological complications.
- To assess the safety of antenatal steroid administration in cases of chorioamnionitis.
Main Methods:
- Review of existing literature and clinical data on chorioamnionitis and its effects on preterm infants.
- Analysis of short-term and long-term neonatal outcomes in relation to histological and clinical chorioamnionitis.
- Examination of the association between prenatal inflammation and conditions like respiratory distress syndrome, bronchopulmonary dysplasia, white matter injury, and sepsis.
Main Results:
- Histological chorioamnionitis shows a short-term benefit in reducing respiratory distress syndrome severity in preterm infants, but increases susceptibility to bronchopulmonary dysplasia.
- Chorioamnionitis is linked to cystic periventricular leukomalacia, intraventricular hemorrhage, and cerebral palsy in preterm infants.
- A single course of antenatal steroids appears safe for both clinical and histological chorioamnionitis.
Conclusions:
- Chorioamnionitis remains a critical factor in preterm birth complications, despite advances in neonatal care.
- While offering some short-term respiratory benefits, chorioamnionitis poses long-term risks for lung injury and neurological damage in neonates.
- Antenatal steroid therapy is a safe intervention for pregnant individuals with chorioamnionitis.
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