OBJECTIVE: The purpose of this study was to determine the incidence of chorioamnionitis and fetal inflammatory response in a stillborn cohort and the relationship of fetal response to spontaneous labor, unexplained antepartum death, and spontaneous preterm death. STUDY DESIGN: In a 15-year hospital cohort study, placental histopathologic evidence, labor onset, gestation, and cause of death classification data were analyzed. RESULTS: Of 459 stillbirths, 428 stillbirths were included. The incidence of chorioamnionitis was 36.9%, with higher rates evident in early and late gestation. A fetal inflammatory response was present in 13.3% and correlated with spontaneous labor and very early spontaneous preterm death. The absence of a fetal response was associated with unexplained antepartum death. CONCLUSION: The increased incidence of chorioamnionitis at extremes of gestation in stillbirth is novel and has important implications. The impact of a fetal response is gestation dependent and its absence is associated with unexplained antepartum death.
OBJECTIVE: The purpose of this study was to determine the incidence of chorioamnionitis and fetal inflammatory response in a stillborn cohort and the relationship of fetal response to spontaneous labor, unexplained antepartum death, and spontaneous preterm death. STUDY DESIGN: In a 15-year hospital cohort study, placental histopathologic evidence, labor onset, gestation, and cause of death classification data were analyzed. RESULTS: Of 459 stillbirths, 428 stillbirths were included. The incidence of chorioamnionitis was 36.9%, with higher rates evident in early and late gestation. A fetal inflammatory response was present in 13.3% and correlated with spontaneous labor and very early spontaneous preterm death. The absence of a fetal response was associated with unexplained antepartum death. CONCLUSION: The increased incidence of chorioamnionitis at extremes of gestation in stillbirth is novel and has important implications. The impact of a fetal response is gestation dependent and its absence is associated with unexplained antepartum death.
Authors: Margo S Harrison; Vanessa R Thorsten; Donald J Dudley; Corette B Parker; Matthew A Koch; Carol J R Hogue; Barbara J Stoll; Robert M Silver; Michael W Varner; M Halit Pinar; Donald R Coustan; George R Saade; Radek K Bukowski; Deborah L Conway; Marian Willinger; Uma M Reddy; Robert L Goldenberg Journal: Am J Perinatol Date: 2018-04-02 Impact factor: 1.862
Authors: Sinéad M O'Neill; Patricia M Kearney; Louise C Kenny; Ali S Khashan; Tine B Henriksen; Jennifer E Lutomski; Richard A Greene Journal: PLoS One Date: 2013-01-23 Impact factor: 3.240