Reduced mortality and increased BPD with histological chorioamnionitis and leukocytosis in very-low-birth-weight infants

Paul, David A.; Zook, Katie; Mackley, Amy; Locke, Robert

doi:10.1038/jp.2009.113

Cited by 13 publications

(8 citation statements)

References 31 publications

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“…Our data source did not include information on clinical definitions or the severity of condition and we were unable to differentiate histological and clinical chorioamnionitis. It is estimated that only 8–52% of women with histological chorioamnionitis will display symptoms of clinical chorioamnionitis [10, 19, 20]. However, these results should be interpreted with caution as they come from a selected subsample of placentas that were sent for histological examination and may not reflect the true correlation between clinical and histological chorioamnionitis.…”

Section: Discussionmentioning

confidence: 99%

Neonatal respiratory morbidity following exposure to chorioamnionitis

et al. 2017

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BackgroundThere are conflicting results in the literature on the impact of chorioamnionitis on neonatal respiratory morbidities. However, most studies are based on small clinical samples and fail to account for the competing risk of perinatal death. This study aimed to determine whether chorioamnionitis affects the incidence of respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) after accounting for the increased risk of death.MethodsRetrospective cohort study using linked birth and infant death registration and hospitalization records from Washington State between 2002 and 2011 (n = 763,671 singleton infants and n = 56,537 singleton preterm infants). Logistic regression models based on the traditional and fetuses-at-risk approaches were used to model two composite outcomes namely RDS and perinatal death and BPD and perinatal death. Confounders adjusted for in the models included maternal age, race, diabetes, hypertension, antenatal corticosteroids, mode of delivery and infant sex.ResultsWhile models using the traditional approach found a significant association only between chorioamnionitis and composite BPD and perinatal death (OR = 1.23, 95% CI: 1.01–1.50); using the fetuses-at-risk approach, there was a significant association between chorioamnionitis and both composite outcomes (RDS and perinatal death OR = 2.74, 2.50–3.01; BPD and perinatal death OR = 5.18, 95% CI: 4.39–6.11).ConclusionThe fetuses-at-risk approach models the causal impact of chorioamnionitis on the development of the fetal lung and shows an increased risk of RDS, BPD and perinatal death associated with such maternal infection.

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Section: Discussionmentioning

confidence: 99%

Neonatal respiratory morbidity following exposure to chorioamnionitis

et al. 2017

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“…Likewise, the definition of histological CA was not consistent across all studies and this inconsistency may account for part of the heterogeneity. For instance, recent studies suggest that markers of fetal inflammatory response (leukocytosis or funisitis) are associated with the development of BPD, whereas CA alone is not 89 90. Finally, the impact of ethnicity and the genetic background on the risk of developing BPD has become more apparent over the last few years and cannot be underestimated 91.…”

Section: Discussionmentioning

confidence: 99%

Chorioamnionitis as a risk factor for bronchopulmonary dysplasia: a systematic review and meta-analysis

Hartling

Liang

Lacaze‐Masmonteil

2011

Arch Dis Child Fetal Neonatal Ed

226

185

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“…BPD is characterized by disruptions in alveologenesis, disordered elastin expression and the absence of alveolar septations during the terminal stage of lung development [5]. Pre-and postnatal in lammatory conditions such as maternal chorioamnionitis, oxygen exposure and mechanical ventilation, as well as subsequent abnormal epithelial development, contribute to the development of BPD [6][7][8][9][10]; however, the mechanisms by which in lammation disrupts alveologenesis are poorly understood.…”

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confidence: 99%