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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Microbial invasion of the amniotic cavity is associated with impaired cognitive and motor function at school age in
Anna Thorell1,2, Maria Hallingström3,4, Henrik Hagberg3,4
1Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Insights
Microbial invasion of the amniotic cavity (MIAC) in preterm infants is linked to lower cognitive and motor skills at school age. These findings highlight the long-term neurodevelopmental impact of intrauterine infections.
Area of Science:
- Neonatal neurodevelopment
- Intrauterine infection
- Preterm birth outcomes
Background:
- Chorioamnionitis is a significant factor in preterm delivery.
- Neurodevelopmental outcomes in infants exposed to intrauterine infection/inflammation are inconsistently reported.
- Challenges exist in diagnosing intrauterine infections and conducting long-term follow-up.
Purpose of the Study:
- To investigate cognitive and motor function in preterm infants at early school age.
- To correlate neurodevelopmental outcomes with microbial invasion of the amniotic cavity (MIAC), histological chorioamnionitis (HCA), and fetal inflammatory response syndrome (FIRS).
Main Methods:
- Sixty-six preterm infants (gestational age <34 weeks) without major disabilities were assessed.
- Cognitive function was evaluated using the WISC-III.
- Motor proficiency was assessed with the Bruininks-Oseretsky Test of Motor Proficiency; results were corrected for gestational age and sex.
Main Results:
- Infants exposed to MIAC showed significantly lower full-scale IQ and verbal IQ scores compared to the non-MIAC group, even after correction for confounding factors.
- The MIAC group also exhibited significantly lower motor scores post-correction.
- Exposure to HCA or FIRS did not affect motor function, and cognitive score differences were lost after corrections.
Conclusions:
- Exposure to bacteria in amniotic fluid (MIAC) is associated with impaired cognitive and motor development in school-aged preterm infants.
- The study highlights the specific impact of MIAC on neurodevelopmental outcomes, differentiating it from HCA and FIRS.
Background:
Chorioamnionitis is an important cause of preterm delivery. Data on neurodevelopmental outcome in exposed infants are inconsistent due to difficulties in diagnosing intrauterine infection/inflammation and lack of detailed long-term follow-up. We investigate cognitive and motor function in preterm infants at early school age and relate the findings to bacteria in amniotic fluid obtained by amniocentesis (microbial invasion of the amniotic cavity (MIAC)) or placenta findings of histological chorioamnionitis (HCA) or fetal inflammatory response syndrome (FIRS).
Method:
Sixty-six infants with gestational age <34 weeks at birth and without major disabilities were assessed using WISC-III and the Bruininks-Oseretsky Test of Motor Proficiency. Results were corrected for gestational age and sex.
Results:
Children exposed to MIAC had significantly lower scores for full-scale IQ and verbal IQ compared to the non-MIAC group and the difference in full-scale IQ remained after correction for confounding factors. The MIAC group had also significantly lower motor scores after correction. In contrast, motor function was not affected in infants exposed to HCA or FIRS and differences between groups for cognitive scores were lost after corrections.
Conclusion:
Exposure to bacteria in amniotic fluid is associated with lower motor and cognitive scores in school age preterm infants without major disabilities.
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