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Histologic Chorioamnionitis and Bronchopulmonary Dysplasia in Preterm Infants: The Epidemiologic Study on Low

Héloïse Torchin1, Elsa Lorthe2, François Goffinet3

  • 1French National Institute of Health and Medical Research Joint Research Unit 1153, Epidemiology and Biostatistics, Center for Epidemiology and Statistics Sorbonne Paris Cité, Department of Risks in Pregnancy, France; Paris Descartes University, Paris, France; Neonatal Medicine and Resuscitation Service in Port-Royal, Public Assistance Hospital of Paris, Cochin Hospital, Paris, France.

The Journal of Pediatrics
|June 7, 2017
PubMed

Insights

Histologic chorioamnionitis (HCA) was associated with a reduced risk of bronchopulmonary dysplasia (BPD) in a general preterm infant population. However, HCA showed no association with BPD in infants born after spontaneous preterm labor or preterm premature rupture of membranes (pPROM).

Area of Science:

  • Neonatalogy
  • Perinatology
  • Pathology

Background:

  • Histologic chorioamnionitis (HCA) is a placental inflammation linked to adverse neonatal outcomes.
  • Bronchopulmonary dysplasia (BPD) is a major complication in very preterm infants.
  • The association between HCA and BPD may vary depending on the mode of preterm birth.

Purpose of the Study:

  • To examine the relationship between HCA and BPD in very preterm infants.
  • To differentiate this association in infants born after spontaneous preterm labor versus preterm premature rupture of membranes (pPROM).

Main Methods:

  • A national prospective population-based cohort of 2513 singletons born at 24-31 weeks gestation.
  • 1731 placental reports were analyzed for HCA, defined by neutrophil infiltrates.
  • Logistic regressions and multiple imputation were used to analyze moderate/severe BPD as the main outcome.

Main Results:

  • Overall HCA incidence was 28.4%, higher in preterm labor (38%) and pPROM (64%).
  • Adjusted analysis revealed HCA was associated with reduced BPD risk overall (aOR 0.6-0.5).
  • This protective association was not observed in subgroups of spontaneous preterm labor or pPROM.

Conclusions:

  • In specific subgroups of spontaneous preterm labor or pPROM, HCA is not significantly associated with BPD.
  • The overall association between HCA and reduced BPD risk may be confounded by factors like fetal growth restriction.
Abstract

Keywords:
bronchopulmonary dysplasiachorioamnionitisinflammationpremature birthpreterm laborpreterm premature rupture of the membranes

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