Association of Histologic Chorioamnionitis With Perinatal Brain Injury and Early Childhood Neurodevelopmental Outcomes Among Preterm Neonates

Bierstone, Daniel; Wagenaar, Nienke; Gano, Dawn; Guo, Ting; Georgio, Gregory; Groenendaal, Floris; Vries, Linda S. de; Varghese, Jojy; Glass, Hannah C.; Chung, Catherine T.; Terry, Jefferson; Rijpert, Maarten; Grunau, Ruth E.; Synnes, Anne; Barkovich, A. James; Ferriero, Donna M.; Benders, Manon J. N. L.; Chau, Vann; Miller, Steven P.

doi:10.1097/01.ogx.0000549830.07599.6f

Cited by 9 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our data largely confirm data from previous population studies obtained in very preterm infants suggesting that the adverse effects of histological chorioamnionitis on infant neurodevelopmental outcomes are mainly related to the complications of prematurity rather than to a direct effect of histologically diagnosed placental inflammation on the brain of preterm fetuses. 11,12 According to these suggestions, Bierstone et al 13 in a cohort multicenter study of neonates 32 weeks' gestational age confirmed that gestational age-related neonatal complications attenuate the apparent adverse effect of chorioamnionitis on infant neurodevelopmental outcome.…”

Section: Discussionmentioning

confidence: 94%

“…8,9 Surprisingly, with the only possible exception of chorioamnionitis, studies on placental lesions of VLBW infants are mostly incomplete, represented by small case series or case-control investigations. 10 The role of chorioamnionitis as an adverse factor in developmental outcomes of VLBW is controversial, [11][12][13] whereas FVM and abruptio placentae have been associated with early markers of infant brain damage. 14,15 The recognition of placental features associated with neurodevelopmental impairment of VLBW could be very useful to identify newborns requiring proper neurodevelopmental follow-up due to an increased risk of developing neurodevelopmental impairments.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Placental Histological Features and Neurodevelopmental Outcomes at Two Years in Very-Low-Birth-Weight Infants

Spinillo

Dominoni

Caporali

et al. 2021

Pediatric Neurology

View full text Add to dashboard Cite

Background: We evaluated the rates of placental pathologic lesions and their relationship with two-year neurodevelopmental outcomes in very-low-birth-weight (VLBW) infants. Methods: This is a cohort observational study comprising 595 VLBW infants during 2007 to 2015. Neurodevelopmental assessment was carried out at 24 months corrected age. Results: In univariate analysis the rates of survival with normal neurodevelopmental outcomes were lower in pregnancies with severe histologic chorioamnionitis (38 of 43, 88.4% when compared with 305 of 450, 67.8%), severe maternal vascular malperfusion (MVM) (17 of 37, 45.9% when compared with 326/ 492, 66.3%), and intravillous hemorrhage (37 of 82, 45.1% when compared with 306 of 449, 68.1%). In logistic models, severe MVM (adjusted odds ratio [adj. OR] ¼ 0.45, 95% confidence interval [CI] ¼ 0.22 to 0.92), severe fetal vascular malperfusion (FVM) (adj. OR ¼ 0.46, 95% CI ¼ 0.22 to 0.45), and intravillous hemorrhage (adj. OR ¼ 0.38, 95% CI ¼ 0.22 to 0.62) were associated with lower rates of infant survival with normal neurodevelopmental outcome. FVM (adj. OR ¼ 0.46, 95% CI ¼ 0.21 to 0.97) and intravillous hemorrhage (adj. OR ¼ 0.37, 95% CI ¼ 0.22 to 0.62) were also the only placental lesions that were independent predictors of a lower rate of intact survival in stepwise analysis for prognostic factors of the entire cohort. Conclusions: Placental pathologic findings such as severe MVM, FVM, and intravillous hemorrhage are significant predictors of neonatal survival and subsequent adverse neurodevelopmental outcomes. Data on the placental pathology could be useful in the neurodevelopmental follow-up of VLBW infants.

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Placental Histological Features and Neurodevelopmental Outcomes at Two Years in Very-Low-Birth-Weight Infants

Spinillo

Dominoni

Caporali

et al. 2021

Pediatric Neurology

View full text Add to dashboard Cite

show abstract

“…A large study of 2390 extremely preterm infants (born <27 weeks' gestational age) from sixteen centers across the United States found infants exposed to histological and clinical chorioamnionitis had an increased risk of cognitive impairment at 18-22 months' corrected age [10]. A separate study of 350 infants found that while gestational age was significantly lower among those with exposure to histological chorioamnionitis, there was no association with intraventricular hemorrhage, white matter injury around birth, or differences in cognitive or motor outcomes at 18-24 months' corrected age [11]. Additional studies have found weak causal or associative roles of chorioamnionitis with cerebral palsy risk [12] and no increased risk of white matter injury on magnetic resonance imaging (MRI) following histological chorioamnionitis in premature infants [13].…”

Section: Chorioamnionitis/intra-amniotic Infection (Iai)mentioning

confidence: 98%

The Impact of Maternal Infection on the Neonate

Ko¹,

Dehority²,

Maxwell³

2021

Congenital Anomalies in Newborn Infants - Clinical and Etiopathological Perspectives

View full text Add to dashboard Cite

Maternal infection is a common occurrence during pregnancy, with a substantial impact on the infant. Some infections result in impaired development in utero and even death of the fetus. Other infections may be insidious in the mother but result in growth impairment and hearing loss in the infant. A growing body of evidence suggests that even infections such as chorioamnionitis, thought to have no longterm impact on the infant, may alter fetal development. This chapter will review congenital infections and their impact on neonatal outcomes, as well as newer findings suggesting that acute infection may result in adverse changes in the infant. We will explore novel mechanisms of pathogenesis and virulence, as well as areas that continue with ongoing research.

show abstract

“…variations in cortical thickness). But research continues to emphasize that postnatal complications from infections, particularly when associated with hypotension in the premature newborn, are associated with an increased risk of white matter injury [33,34].…”

Section: Predisposing Factors For Brain Injurymentioning

confidence: 99%

Pathogenesis and Prevention of Fetal and Neonatal Brain Injury

Macnab¹

2021

Advancement and New Understanding in Brain Injury

View full text Add to dashboard Cite

Recent advances in the clinical management of at-risk pregnancy and care of the newborn have reduced morbidity and mortality among sick neonates, and improved our knowledge of factors that influence the risks of brain injury. In parallel, the refinement of imaging techniques has added to the ability of clinicians to define the etiology, timing and location of pathologic changes with diagnostic and prognostic relevance to the developing fetus and newborn infant. Abnormalities of brain growth, or injury to the developing brain can occur during pregnancy; during labor and delivery, hypoxia, acidosis and ischemia pose major risks to the fetus. Defined practices for the management of pregnancy and delivery, and evidence-based strategies for care in the newborn period are influencing outcome. However, newborn infants, especially those born prematurely, remain at risk from situations that can cause or worsen brain injury. The literature reviewed here explains the mechanisms and timing of injury, and the importance of hypoxia, ischemia, hypotension and infection; describes current diagnostic strategies, neuroimaging technologies and care entities available; and outlines approaches that can be used to prevent or mitigate brain injury. Some show particular promise, and all are relevant to lowering the incidence and severity of brain damage.

show abstract

Association of Histologic Chorioamnionitis With Perinatal Brain Injury and Early Childhood Neurodevelopmental Outcomes Among Preterm Neonates

Cited by 9 publications

References 12 publications

Placental Histological Features and Neurodevelopmental Outcomes at Two Years in Very-Low-Birth-Weight Infants

Placental Histological Features and Neurodevelopmental Outcomes at Two Years in Very-Low-Birth-Weight Infants

The Impact of Maternal Infection on the Neonate

Pathogenesis and Prevention of Fetal and Neonatal Brain Injury

Contact Info

Product

Resources

About