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Effect of chorioamnionitis on postnatal growth in very preterm infants: a population-based study in Japan

Takafumi Ushida1,2, Rena Nosaka3,4, Masahiro Nakatochi5

  • 1Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. u-taka23@med.nagoya-u.ac.jp.

Archives of Gynecology and Obstetrics
|October 1, 2024
PubMed

Insights

Maternal chorioamnionitis (CAM) exposure in preterm infants is linked to accelerated postnatal weight gain, particularly in females, during the first three years of life. This finding highlights a potential impact on growth trajectories for vulnerable newborns.

Area of Science:

  • Neonatal research
  • Perinatal medicine
  • Pediatric growth and development

Background:

  • Chorioamnionitis (CAM) is associated with adverse neonatal outcomes and long-term neurological issues in preterm infants.
  • The impact of CAM on postnatal growth trajectories remains under-investigated.

Purpose of the Study:

  • To evaluate the effect of histological chorioamnionitis (CAM) on the postnatal growth of very preterm infants.
  • To analyze growth trajectories using a nationwide Japanese neonatal database.

Main Methods:

  • A multicenter retrospective study of 4220 preterm infants (birth weight ≤1500g, gestational age <32 weeks).
  • Comparison between CAM (n=2110) and non-CAM (n=2110) groups.
  • Z-scores for height and weight assessed at birth and 3 years; multivariable analyses used to determine the effect of CAM on ΔZ-scores, stratified by sex and CAM stage.

Main Results:

  • Histological CAM was associated with accelerated postnatal weight gain (ΔZ-score) in female preterm infants (β=0.10 [0.00 to 0.20]).
  • No significant association was found for height in females or for height and weight in males.
  • No significant interaction effect of sex on the impact of CAM on growth ΔZ-scores was observed.

Conclusions:

  • Intrauterine exposure to maternal CAM contributes to accelerated postnatal weight gain in female preterm infants within the first three years.
  • This suggests a sex-specific influence of CAM on early growth patterns in very preterm neonates.
Abstract

Keywords:
Catch-up growthHistological chorioamnionitisInflammationPreterm birth

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