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A case-control study of histological chorioamnionitis and neonatal infection
M C de Araujo1, R Schultz, F A Vaz
1Divisão de Pediatria, Hospital Universitário, -HC-HU-FMUSP, Brasil.
Abstract:
The authors report a prospective study of the correlation between histopathological alterations in the placenta and the umbilical cord and neonatal infection in 223 newborns. The pathological studies were specifically concerned with the presence of infection as shown by a polymorphonuclear infiltrate at these sites. Inflammatory lesions were demonstrated in 26.9% of specimens and were highest in those with prolonged premature rupture of membranes and in the least mature placentas. Among the cases of histological chorioamnionitis, only 23.3% of infants had documented infection. Neonatal infection was diagnosed in 7.2% of the newborns and was 10 times more frequent in preterm newborns. Among the cases of infected newborns, 87.5% of placentas had histological chorioamnionitis. Pneumonia and septicemia were the most frequent conditions found among infected newborns. There was a strong correlation between histological chorioamnionitis and neonatal infection. The data obtained in this investigation suggest that histological chorioamnionitis is an important indicator of neonatal infection.
Insights
Histological chorioamnionitis, an infection of the placenta and umbilical cord, strongly correlates with neonatal infection. This finding highlights its importance as an indicator for identifying infants at risk of developing infections.
Area of Science:
- Perinatal Medicine
- Neonatal Pathology
- Infectious Diseases
Background:
- Neonatal infections pose significant risks to infant health.
- Histopathological examination of placental and umbilical cord tissues can reveal signs of intrauterine infection.
- Understanding the correlation between placental pathology and neonatal outcomes is crucial for early intervention.
Purpose of the Study:
- To investigate the correlation between histopathological alterations in the placenta and umbilical cord and the incidence of neonatal infection.
- To determine the predictive value of histological chorioamnionitis for neonatal infection.
Main Methods:
- Prospective study involving 223 newborns.
- Pathological examination of placental and umbilical cord specimens for polymorphonuclear infiltrate (infection).
- Clinical diagnosis of neonatal infection, including pneumonia and septicemia.
Main Results:
- Inflammatory lesions (histological chorioamnionitis) were found in 26.9% of specimens, particularly with prolonged premature rupture of membranes and immature placentas.
- Neonatal infection occurred in 7.2% of newborns, being 10 times more frequent in preterm infants.
- A strong correlation was observed: 87.5% of infected newborns had histological chorioamnionitis.
Conclusions:
- Histological chorioamnionitis is a significant indicator of neonatal infection.
- Early identification of histological chorioamnionitis may aid in predicting and preventing neonatal infections.
- The study underscores the importance of placental examination in assessing neonatal infection risk.