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Impact of histological chorioamnionitis on postnatal growth in very-low birth weight infants
Elsa García González1, Montserrat Izquierdo Renau1, Victoria Aldecoa-Bilbao2
1Neonatology Department, Hospital Sant Joan de Déu, BCNatal, Institut de Reçerca Sant Joan de Déu, Barcelona, Spain.
Insights
Histological chorioamnionitis (CA) did not impact postnatal growth in very preterm infants. Growth trajectories were similar between infants with and without CA, showing a consistent decline without catch-up growth.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Growth
Background:
- Postnatal growth restriction is a significant challenge for very preterm infants (VPI).
- Chorioamnionitis (CA), a frequent cause of prematurity, is linked to adverse postnatal outcomes.
- The specific impact of histological CA on VPI growth requires further elucidation.
Purpose of the Study:
- To investigate the effect of histological chorioamnionitis (CA) on the postnatal growth patterns of very premature infants.
- To compare growth trajectories in VPI exposed to histological CA versus those not exposed.
Main Methods:
- A retrospective, one-to-one matched cohort study was conducted.
- Infants born at or below 32.0 weeks gestation with available placental histology were assessed.
- Growth was measured at key time points: admission, 14 days, 28 days, and 36 weeks postmenstrual age (PMA), with adjustments for nutritional support and clinical outcomes.
Main Results:
- Eighty-eight VPI were analyzed (44 with histological CA, 44 without).
- Weight z-score changes at 14 days, 28 days, 36 weeks PMA, and discharge were comparable between groups.
- Both groups exhibited a steady decline in weight z-scores without catch-up growth; nutritional intake also showed no significant differences.
Conclusions:
- Histological chorioamnionitis (CA) does not appear to influence postnatal growth in very preterm infants when matched for birth weight z-scores.
- Growth patterns in VPI are characterized by a consistent fall, irrespective of histological CA presence.
- Further research may explore other factors influencing growth in this vulnerable population.
Background:
Postnatal growth restriction remains one of the most common problems of very preterm infants (VPI). Chorioamnionitis is a frequent cause of prematurity. Both have been related to worse postnatal outcomes.
Objectives:
To evaluate the influence of histological chorioamnionitis (CA) on postnatal growth in very premature infants.
Methods:
Retrospective one-to-one matched cohort study assessing growth in infants born at or below 32.0 weeks gestation from mothers for whom histological examination of the placenta was available. Newborns with histological CA were matched and compared with those without it. Postnatal growth was recorded at admission, 14 days of life, 28 days of life and 36 weeks postmenstrual age (PMA). Nutritional support and clinical outcomes were used as covariables.
Results:
Eighty-eight patients were included: 44 with fetal or/and maternal placental inflammation, and 44 without histological CA (41% with vasculopathy findings and 59% without). Baseline characteristics were similar between the groups. Change in weight z-scores at 14 days of life, 28 days of life, 36 weeks PMA or at discharge were similar in both groups, with a steady fall and no signs of catch-up. No differences were found in enteral and parenteral nutritional intakes between groups.
Conclusions:
Histological CA did not affect postnatal growth of very preterm infants after matching for birth weight z-scores with non-CA newborns.
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