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Updated: May 12, 2025
A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
Published on: June 24, 2020
Role of Intrauterine Infectious and Inflammatory Complications in the Development of Necrotizing Enterocolitis in a
Jana Leskova, Marian Kacerovsky1, Julie Ledvinova2,3,4
1Department of Pediatric Surgery and Traumatology, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czechia.
Introduction:
This study aimed to evaluate whether the presence of microbial invasion of the amniotic cavity (MIAC) and/or acute histological chorioamnionitis (HCA), as well as their subtypes, in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) is related to the subsequent development of necrotizing enterocolitis (NEC) in newborns from these pregnancies.
Methods:
This retrospective study included 295 women with singleton pregnancies complicated by PPROM between gestational ages 24+0 and 31+6 weeks who underwent transabdominal amniocentesis. MIAC was detected using a combination of cultivated and noncultivated methods. HCA was revealed by histopathological examination of the placenta. Only neonates with stage IIa of the modified Bell's criteria were considered to have NEC.
Results:
NEC developed in 3% (10/295) of newborns. There were no differences in the rates of MIAC (p = 0.33), HCA with the absence (p = 1.00) or presence of fetal inflammatory response (p = 0.52), and HCA with acute inflammation of the amnion (p = 0.20) between those who developed and did not develop NEC.
Conclusion:
Neither MIAC nor HCA was associated with the development of NEC in newborns from singleton pregnancies complicated by PPROM between 24+0 and 31+6 weeks of gestation.
Insights
Microbial invasion of the amniotic cavity (MIAC) and acute histological chorioamnionitis (HCA) do not increase the risk of necrotizing enterocolitis (NEC) in infants born after preterm prelabor rupture of membranes (PPROM). This finding suggests these infections are not predictive of NEC development.
Area of Science:
- Perinatal Medicine
- Neonatalogy
- Infectious Disease
Background:
- Preterm prelabor rupture of membranes (PPROM) is a significant risk factor for adverse neonatal outcomes.
- Microbial invasion of the amniotic cavity (MIAC) and acute histological chorioamnionitis (HCA) are common complications of PPROM.
- Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition affecting preterm infants.
Purpose of the Study:
- To investigate the association between MIAC and/or HCA in pregnancies with PPROM and the subsequent development of NEC in neonates.
- To determine if specific subtypes of MIAC or HCA influence NEC risk.
Main Methods:
- Retrospective study of 295 singleton pregnancies with PPROM (24-31 weeks gestation).
- Transabdominal amniocentesis for MIAC detection (cultivated and non-cultivated methods).
- Histopathological placental examination for HCA; NEC defined by modified Bell's criteria (stage IIa).
Main Results:
- NEC developed in 3% of newborns.
- No significant differences in MIAC rates between NEC and non-NEC groups (p=0.33).
- No significant differences in HCA rates (with or without fetal inflammatory response, or with amnion inflammation) between NEC and non-NEC groups (p=1.00, p=0.52, p=0.20 respectively).
Conclusions:
- Neither MIAC nor HCA is associated with an increased risk of NEC in neonates born from pregnancies complicated by PPROM.
- These findings suggest that intra-amniotic infection markers may not be reliable predictors for NEC development in this specific preterm population.
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