New diagnostic criteria for clinical chorioamnionitis using only objective indicators: A retrospective study

Area of Science:

• Perinatal Medicine
• Infectious Diseases
• Obstetrics

Background:

• Chorioamnionitis is a major perinatal infection impacting maternal and infant health.
• Current diagnostic criteria, like Lencki's, rely on subjective measures, reducing clinical usefulness.
• Objective diagnostic indicators are needed for reliable chorioamnionitis assessment.

Purpose of the Study:

• To develop and validate new diagnostic criteria for chorioamnionitis using only objective indicators.
• To improve the accuracy of chorioamnionitis diagnosis compared to existing methods.

Main Methods:

• Retrospective cohort study of 862 patients with placental pathology examination.
• Classification based on Blanc criteria into Chorioamnionitis (CAM) stages II/III and CAM I.
• Multivariate logistic regression to identify objective diagnostic indicators and develop a scoring model.
• Receiver operating characteristic (ROC) curve analysis to compare diagnostic performance.

Main Results:

• The new model assigned points for fever (≥38.5°C), elevated C-reactive protein (≥1.0 mg/dL), high white blood cell count (≥12 × 10⁹/L), and nulliparity.
• A total score of ≥4 indicated chorioamnionitis.
• The new criteria demonstrated superior diagnostic performance (AUC 0.741) compared to existing criteria (AUC 0.621).
• CAM II/III group had higher rates of neonatal acidosis and prolonged postpartum hospitalization.

Conclusions:

• The developed objective criteria offer improved diagnostic accuracy for chorioamnionitis.
• Early and accurate diagnosis can lead to timely interventions.
• Enhanced diagnostic accuracy is crucial for improving perinatal outcomes in cases of chorioamnionitis.