Funisitis Predicts Poor Respiratory Outcomes in Extremely Preterm Neonates

Area of Science:

• Neonatology
• Perinatal Medicine
• Pulmonology

Background:

• Histological chorioamnionitis (HCAM) is a known risk factor for chronic lung disease (CLD) in preterm neonates.
• Funisitis, indicating fetal inflammatory response, is linked to adverse outcomes, but its specific impact on respiratory health in extremely preterm infants requires further clarification.

Purpose of the Study:

• To investigate the association between HCAM with funisitis and poorer respiratory outcomes compared to HCAM alone in preterm neonates (gestational age 22-36 weeks).

Main Methods:

• Retrospective cohort study involving very low-birth weight (VLBW) preterm neonates with placental histopathology.
• Classification into three groups: normal, isolated HCAM, and HCAM with funisitis.
• Comparison of perinatal characteristics, radiographic findings, morbidities, and respiratory outcomes.

Main Results:

• Neonates with HCAM and funisitis had lower gestational age and higher rates of clinical chorioamnionitis.
• Higher incidence of cystic-interstitial lung changes and CLD in the HCAM with funisitis group compared to isolated HCAM and normal groups.
• Funisitis independently predicted CLD development (adjusted odds ratio 15.259) more strongly than HCAM alone (adjusted odds ratio 3.841).

Conclusions:

• Funisitis is an independent predictor of poor respiratory outcomes in extremely preterm infants.
• The presence of funisitis, in addition to HCAM, significantly increases the risk of CLD.
• Further investigation into the long-term clinical impacts of funisitis in preterm infants is warranted.