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Histologic chorioamnionitis and preterm delivery in different patient populations
E Mueller-Heubach1, D N Rubinstein, S S Schwarz
1Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine, Magee-Woemns Hospital, Pennsylvania.
Obstetrics and Gynecology
|April 1, 1990
Summary
Histologic chorioamnionitis is more common and severe in preterm births. Higher preterm birth rates in Black and indigent populations are not linked to increased chorioamnionitis frequency or severity.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Pathology
Background:
- Chorioamnionitis, an infection of the placenta and fetal membranes, is a significant risk factor for adverse perinatal outcomes.
- The prevalence and severity of chorioamnionitis may vary based on delivery mode, gestational age, and patient demographics.
- Understanding these variations is crucial for optimizing perinatal care and reducing complications.
Purpose of the Study:
- To investigate the frequency and severity of histologic chorioamnionitis in relation to delivery mode, gestational age, and patient characteristics.
- To determine if chorioamnionitis contributes to the higher rates of preterm birth observed in certain demographic groups.
Main Methods:
- Placental examination of 1843 deliveries for histologic chorioamnionitis, classified as mild, moderate, or severe.
- Analysis of chorioamnionitis prevalence and severity in relation to cesarean delivery before labor, term delivery, and preterm delivery.
- Comparison of chorioamnionitis rates and severity across different gestational ages, membrane status (intact vs. premature rupture of membranes), and patient populations (race, socioeconomic status).
Main Results:
- Chorioamnionitis was present in 7.5% of cesarean deliveries before labor, 18% of term deliveries, and 32% of preterm deliveries.
- Severe chorioamnionitis was significantly more common in preterm (74%) than term deliveries (15%).
- While chorioamnionitis was equally frequent in preterm and term births with intact membranes, it was more severe in preterm births.
- Higher preterm birth rates in Black and indigent populations were not associated with increased frequency or severity of chorioamnionitis, although severe chorioamnionitis was more common in Black patients with term births.
Conclusions:
- Chorioamnionitis is more prevalent and severe in preterm deliveries, with severity inversely related to gestational age.
- The higher incidence of preterm birth in Black and indigent populations is not attributable to a greater frequency or severity of chorioamnionitis.
- Further research may be needed to identify other factors contributing to disparities in preterm birth rates.