Maternal Chorioamnionitis and Postneonatal Respiratory Tract Infection in Ex-Preterm Infants

Burgner, David; Doherty, Dorota A.; Humphreys, James W.; Currie, Andrew; Simmer, Karen; Charles, Adrian; Strunk, Tobias

doi:10.1016/j.jpeds.2017.01.037

Cited by 10 publications

(12 citation statements)

References 32 publications

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“…While we did find a higher proportion of infants with RVIs having placental chorioamnionitis, this was not significant in the regression analysis. This is in contrast to the recent findings of increased risk of lower respiratory tract infection in infants with histologic chorioamnionitis [40].…”

Section: Clinical Risk Factorscontrasting

confidence: 99%

“…For our analysis, we only included perinatal and predischarge factors and were unable to analyze the contribution of social and environmental factors that may lead to RVIs postdischarge [9]. Unlike other studies, we did not find sex, chorioamnionitis, or SGA status to be significant risks for RVI in our cohort [39,40]. While we did find a higher proportion of infants with RVIs having placental chorioamnionitis, this was not significant in the regression analysis.…”

Section: Clinical Risk Factorscontrasting

confidence: 68%

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Burden, Etiology, and Risk Factors of Respiratory Virus Infections Among Symptomatic Preterm Infants in the Tropics: A Retrospective Single-Center Cohort Study

Yeo

Puerta

Tee

et al. 2018

Clinical Infectious Diseases

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Section: Clinical Risk Factorscontrasting

confidence: 99%

Section: Clinical Risk Factorscontrasting

confidence: 68%

Burden, Etiology, and Risk Factors of Respiratory Virus Infections Among Symptomatic Preterm Infants in the Tropics: A Retrospective Single-Center Cohort Study

Yeo

Puerta

Tee

et al. 2018

Clinical Infectious Diseases

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“…Reported data came from 37 publications from Europe (23 distinct data sources) [13,18,, 38 publications from North America (19 data sources) [3,, 19 from Asia (16 data sources) [94][95][96][97][98][99][100][101][102][103][104][105][106][107][108][109][110][111][112], and six from Oceania (Australia and New Zealand; six data sources) [113][114][115][116][117][118]. Additionally, two publications included data from both Europe and North America [119,120], and one publication included stratified data from both Asia and North America [121].…”

Section: Literature Search Resultsmentioning

confidence: 99%

Global incidence of bronchopulmonary dysplasia among extremely preterm infants: a systematic literature review

Siffel

Kistler

Lewis

et al. 2019

The Journal of Maternal-Fetal & Neonatal Medicine

171

110

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Background: Infants born extremely preterm (<28 weeks gestational age (GA)) face a high risk of neonatal mortality. Bronchopulmonary dysplasia (BPD) is the most common morbidity of prematurity. Objective: To evaluate the global incidence of BPD among infants born extremely preterm. Design: A systematic review of the literature was conducted in Embase and MEDLINE (via PubMed) using a prespecified search strategy for BPD and prematurity. Observational studies published in English between 16 May 2006 and 16 October 2017 reporting on the occurrence of BPD in infants born <28 weeks GA were included. Results: Literature searches yielded 103 eligible studies encompassing 37 publications from Europe, 38 publications from North America, two publications from Europe and North America, 19 publications from Asia, one publication from Asia and North America, six publications from Oceania, and zero publications from Africa or South America. The reported global incidence range of BPD was 10-89% (10-73% in Europe, 18-89% in North America, 18-82% in Asia, and 30-62% in Oceania). When only population-based observational studies that defined BPD as requiring supplemental oxygen at 36 weeks postmenstrual age were included, the global incidence range of BPD was 17-75%. The wide range of incidences reflected interstudy differences in GA (which was inversely related to BPD incidence), birthweight, and survival rates across populations and institutions. Conclusions: BPD is a common health morbidity occurring with extremely preterm birth. Further study of factors that impact incidence, aside from low GA, may help to elucidate modifiable risks.

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“…No studies have investigated epigenetic changes associated with chorioamnionitis‐exposure. This would be of interest as bacterial infection can induce a variety of epigenetic changes in the host including histone modifications and DNA methylation, and chorioamnionitis‐exposure is associated with differential infection risk …”

Section: Discussionmentioning

confidence: 99%

“…This would be of interest as bacterial infection can induce a variety of epigenetic changes in the host including histone modifications and DNA methylation, 41 and chorioamnionitis-exposure is associated with differential infection risk. 5,42 We acknowledge some limitations. The sample sizes are relatively small and not matched for gender.…”

Section: Discussionmentioning

confidence: 99%

Exposure to chorioamnionitis alters the monocyte transcriptional response to the neonatal pathogen Staphylococcus epidermidis

et al. 2018

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Preterm infants are uniquely susceptible to late-onset sepsis that is frequently caused by the skin commensal Staphylococcus epidermidis. Innate immune responses, particularly from monocytes, are a key protective mechanism. Impaired cytokine production by preterm infant monocytes is well described, but few studies have comprehensively assessed the corresponding monocyte transcriptional response. Innate immune responses in preterm infants may be modulated by inflammation such as prenatal exposure to histologic chorioamnionitis which complicates 40-70% of preterm pregnancies. Chorioamnionitis alters the risk of late-onset sepsis, but its effect on monocyte function is largely unknown. Here, we aimed to determine the impact of exposure to chorioamnionitis on the proportions and phenotype of cord blood monocytes using flow cytometry, as well as their transcriptional response to live S. epidermidis. RNA-seq was performed on purified cord blood monocytes from very preterm infants (<32 weeks gestation, with and without chorioamnionitis-exposure) and term infants (37-40 weeks), pre- and postchallenge with live S. epidermidis. Preterm monocytes from infants without chorioamnionitis-exposure did not exhibit an intrinsically deficient transcriptional response to S. epidermidis compared to term infants. In contrast, chorioamnionitis-exposure was associated with hypo-responsive transcriptional phenotype regarding a subset of genes involved in antigen presentation and adaptive immunity. Overall, our findings suggest that prenatal exposure to inflammation may alter the risk of sepsis in preterm infants partly by modulation of monocyte responses to pathogens.

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Maternal Chorioamnionitis and Postneonatal Respiratory Tract Infection in Ex-Preterm Infants

Cited by 10 publications

References 32 publications

Burden, Etiology, and Risk Factors of Respiratory Virus Infections Among Symptomatic Preterm Infants in the Tropics: A Retrospective Single-Center Cohort Study

Burden, Etiology, and Risk Factors of Respiratory Virus Infections Among Symptomatic Preterm Infants in the Tropics: A Retrospective Single-Center Cohort Study

Global incidence of bronchopulmonary dysplasia among extremely preterm infants: a systematic literature review

Exposure to chorioamnionitis alters the monocyte transcriptional response to the neonatal pathogen Staphylococcus epidermidis

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