Chorioamnionitis, lung function and bronchopulmonary dysplasia in prematurely born infants

Prendergast, Michael; May, Caroline; Broughton, Simon; Pollina, Elena; Milner, Anthony; Rafferty, Gerrard F.; Greenough, Anne

doi:10.1136/adc.2010.189480

Cited by 34 publications

(24 citation statements)

References 34 publications

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“…Our findings are also consistent with previous findings of no significant effect of chorioamnionitis on iPFT variables in both early and late preterm infants at 6 to 12 months' age (16). Although Prendergast and colleagues (16) performed lung function studies before discharge from the birth hospitalization, we performed iPFT at about 9 months' postnatal age.…”

Section: Original Researchsupporting

confidence: 81%

“…Although Prendergast and colleagues (16) performed lung function studies before discharge from the birth hospitalization, we performed iPFT at about 9 months' postnatal age. However, in contrast to Jones and colleagues (17), who found a selective decrease in lung function in preterm girls with chorioamnionitis compared with girls without chorioamnionitis, we found that boys had lower lung function than girls.…”

Section: Original Researchmentioning

confidence: 99%

“…Prendergast and colleagues (16), and Jones and colleagues (17) measured lung function in a cohort of preterm infants born at 23 to 36 weeks either in the neonatal period or in the first year of life. After adjusting for prematurity, neither study found differences in lung function between preterm infants with and without chorioamnionitis.…”

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confidence: 99%

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Pulmonary Morbidity in Infancy after Exposure to Chorioamnionitis in Late Preterm Infants

et al. 2016

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Rationale: Chorioamnionitis is an important cause of preterm birth, but its impact on postnatal outcomes is understudied.Objectives: To evaluate whether fetal exposure to inflammation is associated with adverse pulmonary outcomes at 6 to 12 months' chronological age in infants born moderate to late preterm. Methods:Infants born between 32 and 36 weeks' gestational age were prospectively recruited (N = 184). Chorioamnionitis was diagnosed by placenta and umbilical cord histology. Select cytokines were measured in samples of cord blood. Validated pulmonary questionnaires were administered (n = 184), and infant pulmonary function testing was performed (n = 69) between 6 and 12 months' chronological age by the raised volume rapid thoracoabdominal compression technique. Measurements and Main Results:A total of 25% of participants had chorioamnionitis. Although infant pulmonary function testing variables were lower in infants born preterm compared with historical normative data for term infants, there were no differences between infants with chorioamnionitis (n = 20) and those without (n = 49). Boys and black infants had lower infant pulmonary function testing measurements than girls and white infants, respectively. Chorioamnionitis exposure was associated independently with wheeze (odds ratio [OR], 2.08) and respiratory-related physician visits (OR, 3.18) in the first year of life. Infants exposed to severe chorioamnionitis had increased levels of cord blood IL-6 and greater pulmonary morbidity at age 6 to 12 months than those exposed to mild chorioamnionitis. Elevated IL-6 was associated with significantly more respiratory problems (OR, 3.23).Conclusions: In infants born moderate or late preterm, elevated cord blood IL-6 and exposure to histologically identified chorioamnionitis was associated with respiratory morbidity during infancy without significant changes in infant pulmonary function testing measurements. Black compared with white and boy compared with girl infants had lower infant pulmonary function testing measurements and worse pulmonary outcomes.

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Section: Original Researchsupporting

confidence: 81%

Section: Original Researchmentioning

confidence: 99%

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Pulmonary Morbidity in Infancy after Exposure to Chorioamnionitis in Late Preterm Infants

et al. 2016

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“…In a recent casecontrol study, chorioamnionitis was associated with an increased risk of BPD but only if the infants subsequently developed postnatal infection or required mechanical ventilation for more than 7 days. This led the authors to postulate a 'double hit' theory for BPD development [29] . Therefore, the relatively high incidence of BPD in the context of prolonged oligohydramnios may be related to a combination of altered antenatal lung development, infection, inflammation and the effects of postnatal respiratory management.…”

Section: Inflammation and Infectionmentioning

confidence: 99%

Pulmonary Effects of Prolonged Oligohydramnios following Mid-Trimester Rupture of the Membranes – Antenatal and Postnatal Management

Williams¹,

Hutchings

Hubinont

et al. 2011

Neonatology

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Mid-trimester, preterm prelabour rupture of the membranes (PPROM) with prolonged oligohydramnios remains a challenge for both obstetricians and neonatologists. Although survival rates have improved, morbidity remains common particularly due to pulmonary insufficiency and pulmonary hypertension. The aetiology of abnormal lung development is unknown but may depend critically on pulmonary vascular development. Antenatal evaluation of at-risk foetuses by three-dimensional ultrasound and MRI is possible but the techniques need to be further assessed. Antenatal corticosteroids given in cases of PPROM reduce the incidence of neonatal death, respiratory distress syndrome, intraventricular haemorrhage and necrotising enterocolitis without increasing maternal or neonatal infection. The true risk-benefit ratio of antibiotics, tocolysis and strategies to normalise amniotic fluid volume remains less clear. There is no consensus regarding the optimal ventilation strategy to support infants with pulmonary insufficiency following PPROM, and further work is required to determine whether and which pulmonary vasodilators improve long-term outcome in these infants.

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“…Paananen R et al (2009) reported that elevated plasma concentrations of IL-6, a pro-inflammatory cytokine, and IL-10, an anti-inflammatory cytokine, on the first day of life were indicative of greater BPD risk, independently of previous exposure to chorioamnionitis (39% of the 128 preterm neonates in the cohort had had chorioamnionitis; incidence of BPD in cohort, 25%). The lack of correlation between an initial inflammatory process and BPD development was confirmed in 2010 in a study investigating the association between chorioamnionitis and BPD (Prendergast, et al, 2010). From the 71 preterm infants developing BPD, 41 had been exposed to chorioamnionitis and/or funisitis.…”

Section: Inflammationmentioning

confidence: 92%

Bronchopulmonary Dysplasia: The Role of Oxidative Stress

Lavoie¹,

Mohamed²

2012

Lung Diseases - Selected State of the Art Reviews

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Chorioamnionitis, lung function and bronchopulmonary dysplasia in prematurely born infants

Abstract: In prematurely born infants, routinely exposed to antenatal steroids and postnatal surfactant, chorioamnionitis was not associated with worse lung function or more severe BPD.

Cited by 34 publications

References 34 publications

Pulmonary Morbidity in Infancy after Exposure to Chorioamnionitis in Late Preterm Infants

Pulmonary Morbidity in Infancy after Exposure to Chorioamnionitis in Late Preterm Infants

Pulmonary Effects of Prolonged Oligohydramnios following Mid-Trimester Rupture of the Membranes – Antenatal and Postnatal Management

Bronchopulmonary Dysplasia: The Role of Oxidative Stress

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