Chorioamnionitis is a major cause of maternal and neonatal morbidity. The term refers to inflammation of the amniotic fluid, membranes, placenta, and/or decidua and has been strongly associated with premature labor, occurring in 30% of babies born after premature labor with intact membranes and in 75% with premature rupture of membranes (PROM). 1 The incidence of chorioamnionitis varies considerably depending on the gestational age at the time of delivery, with rates as high as 41% in those born at less than 27 weeks' gestation, 15% between 28 to 36 weeks' gestation, and 2% at term gestation. 2 Most cases of chorioamnionitis are a consequence of intra-amniotic infection that has four main sources including ascending infection through the vagina, hematogenous spread through the placenta, retrograde seeding from AbstractChorioamnionitis contributes to neonatal and maternal morbidity and mortality. We aimed to evaluate of the impact of clinical and histological chorioamnionitis on mortality and morbidity of preterm infants. Maternal and neonatal data were collected in a retrospective cohort of preterm infants less than 30 weeks' gestation. Infants were divided into three groups: those born to mothers with clinical chorioamnionitis, histological chorioamnionitis, or no chorioamnionitis. Of 274 identified preterm infants, 33 infants were born to mothers with clinical chorioamnionitis, 95 to mothers with histological chorioamnionitis, and 146 to mothers with no chorioamnionitis. Data were available for 180 (78%) of the 230 survivors at 18 months corrected age. Infants in the study groups were similar in gestational age, birth weight, and sex distribution. Clinical and histological chorioamnionitis were not predictive of infant mortality, cerebral palsy, bronchopulmonary dysplasia, periventricular leukomalacia, or retinopathy of prematurity. Infants in the clinical chorioamnionitis group had significantly lower cognitive (88 AE 10), language (82 AE 12), and motor (89 AE 11) scores compared with infants in the histological chorioamnionitis group (101 AE 13, p < 0.01; 91 AE 13, p < 0.05; and 99 AE 13, p < 0.05, respectively) and to infants in the no chorioamnionitis group (99 AE 13, p < 0.01; 92 AE 15, p < 0.05; and 97 AE 13, p < 0.05, respectively). Clinical chorioamnionitis is associated with developmental delay in preterm infants despite adequate treatment.

Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in the NICU, with often devastating consequences. The etiology of NEC is probably multifactorial, with preterm infants at the highest risk. The relationship between feeding and NEC was identified in the 1970s, leading to delayed feeding becoming standard treatment in NICUs. More recent research suggests that early feedings not only are safe, but reduce other morbidities associated with prematurity. Standardized feeding guidelines seem to confer some benefits in decreasing NEC, despite a wide variability in feeding practices within the published guidelines. A standardized approach to the management of feeding problems may be the key. This article briefly reviews the pathogenesis of NEC and examines studies of various feeding practices for their relationship to the development of NEC. It also highlights the potential benefits of breast milk in NEC prevention.

We conclude that reintubation after cardiac operations should be avoided since nCPAP and NPPV are safe and effectively improve arterial oxygenation in the majority of patients with nonhypercapnic oxygenation failure. However, it is of great importance to pay special care to sternal wound complications in these patients.

In this cohort of preterm infants, the majority exhibited greater diaphragm activation, as assessed by neural breathing patterns, when supported with HFNC than IF-CPAP, suggesting that nasal CPAP may provide more effective respiratory support.