BACKGROUND: The role of chorioamnionitis in neurodevelopment of preterm infants is not fully understood. AIM: To examine the association between different indicators of intrauterine inflammation (clinical chorioamnionitis, histological chorioamnionitis and funisitis) and neurodevelopmental impairment in very preterm infants. METHODS: Preterm infants with a birth weight of <1500 g or a gestational age of <32 weeks were included. Follow-up evaluation up to 2 years of age consisted of neurological examination, neurodevelopmental assessment and visual and audiologic tests. Outcome data were compared between the chorioamnionitis and the control groups, controlling for gestational age, birth weight and Apgar score at 5 min. RESULTS: One hundred seventy-seven patients comprised the study population (mean gestational age 29±2 weeks, mean birth weight 1167±344 g). Histological chorioamnionitis was present in 49% of placentas, whereas funisitis was observed in 25%. In 57% cases clinical maternal chorioamnionitis was suspected. Follow-up was available for 130 (82%) patients. Infants with funisitis, compared with controls, had a significantly higher incidence of moderate to severe disability (18% vs 5%, OR 4.07; 95% CI 1.10-15.09). CONCLUSION: The results of this study suggest that, unlike a broad definition of histological chorioamnionitis including inflammation of maternal or fetal placental tissues, funisitis may entail a higher risk of moderate to severe disability at 2 years of age in preterm infants.
BACKGROUND: The role of chorioamnionitis in neurodevelopment of preterm infants is not fully understood. AIM: To examine the association between different indicators of intrauterine inflammation (clinical chorioamnionitis, histological chorioamnionitis and funisitis) and neurodevelopmental impairment in very preterm infants. METHODS: Preterm infants with a birth weight of <1500 g or a gestational age of <32 weeks were included. Follow-up evaluation up to 2 years of age consisted of neurological examination, neurodevelopmental assessment and visual and audiologic tests. Outcome data were compared between the chorioamnionitis and the control groups, controlling for gestational age, birth weight and Apgar score at 5 min. RESULTS: One hundred seventy-seven patients comprised the study population (mean gestational age 29±2 weeks, mean birth weight 1167±344 g). Histological chorioamnionitis was present in 49% of placentas, whereas funisitis was observed in 25%. In 57% cases clinical maternal chorioamnionitis was suspected. Follow-up was available for 130 (82%) patients. Infants with funisitis, compared with controls, had a significantly higher incidence of moderate to severe disability (18% vs 5%, OR 4.07; 95% CI 1.10-15.09). CONCLUSION: The results of this study suggest that, unlike a broad definition of histological chorioamnionitis including inflammation of maternal or fetal placental tissues, funisitis may entail a higher risk of moderate to severe disability at 2 years of age in preterm infants.
Authors: Ruth Gussenhoven; Daan R M G Ophelders; Matthew W Kemp; Matthew S Payne; Owen B Spiller; Michael L Beeton; Sarah J Stock; Bertha Cillero-Pastor; Florian P Y Barré; Ron M A Heeren; Lilian Kessels; Bas Stevens; Bart P Rutten; Suhas G Kallapur; Alan H Jobe; Boris W Kramer; Tim G A M Wolfs Journal: Dev Neurosci Date: 2017-08-29 Impact factor: 2.984
Authors: S M Lee; J S Park; E R Norwitz; S Oh; E J Kim; S M Kim; J Lee; B J Kim; C-W Park; J K Jun Journal: J Perinatol Date: 2015-04-09 Impact factor: 2.521
Authors: Ariel A Salas; Ona M Faye-Petersen; Brian Sims; Myriam Peralta-Carcelen; Stephanie D Reilly; Gerald McGwin; Waldemar A Carlo; Namasivayam Ambalavanan Journal: J Pediatr Date: 2013-05-08 Impact factor: 4.406
Authors: Athina Pappas; Douglas E Kendrick; Seetha Shankaran; Barbara J Stoll; Edward F Bell; Abbott R Laptook; Michele C Walsh; Abhik Das; Ellen C Hale; Nancy S Newman; Rosemary D Higgins Journal: JAMA Pediatr Date: 2014-02 Impact factor: 16.193
Authors: Teresa Cobo; Marian Kacerovsky; Ctirad Andrys; Marcela Drahosova; Ivana Musilova; Helena Hornychova; Bo Jacobsson Journal: PLoS One Date: 2013-07-24 Impact factor: 3.240