Cecilia Avila1, Jennifer L Willins1, Matthew Jackson2, Jacob Mathai1, Marina Jabsky1, Alex Kong1, Fiona Callaghan3, Selda Ishkin1, A Laurie W Shroyer4. 1. Department of Obstetrics, Gynecology, and Reproductive Medicine, Stony Brook University School of Medicine, Stony Brook, New York. 2. U.S. Food and Drug Administration, CDER/OTS/OB/DB6, Silver Spring, Maryland. 3. Lister Hill Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, Maryland. 4. Department of Surgery, Stony Brook University School of Medicine, Stony Brook, New York.
Abstract
OBJECTIVE: To assess the usefulness of two definitions of acute clinical chorioamnionitis (ACCA) in predicting risk of neonatal infectious outcomes (NIO) and mortality, the first definition requiring maternal fever alone (Fever), and the second requiring ≥ 1 Gibbs criterion besides fever (Fever + 1). STUDY DESIGN: PubMed, Web of Science, and the Cochrane Database of Systematic Reviews were searched from January 1, 1979 to April 9, 2013. Twelve studies were reviewed (of 316 articles identified): three studies with term patients, four with preterm premature rupture of membranes (PPROM) patients, and five mixed studies with mixed gestational ages and/or membrane status (intact and/or ruptured). RESULTS: Both definitions demonstrated an increased NIO risk for ACCA versus non-ACCA patients, with an odds ratio increase for the Fever + 1 definition that was about twofold larger than the Fever definition. CONCLUSION: As the Fever definition demonstrated increased NIO risk for ACCA versus non-ACCA patients, the Fever alone ACCA definition should be used to trigger future clinical treatment in many clinical situations. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: To assess the usefulness of two definitions of acute clinical chorioamnionitis (ACCA) in predicting risk of neonatal infectious outcomes (NIO) and mortality, the first definition requiring maternal fever alone (Fever), and the second requiring ≥ 1 Gibbs criterion besides fever (Fever + 1). STUDY DESIGN: PubMed, Web of Science, and the Cochrane Database of Systematic Reviews were searched from January 1, 1979 to April 9, 2013. Twelve studies were reviewed (of 316 articles identified): three studies with term patients, four with preterm premature rupture of membranes (PPROM) patients, and five mixed studies with mixed gestational ages and/or membrane status (intact and/or ruptured). RESULTS: Both definitions demonstrated an increased NIO risk for ACCA versus non-ACCA patients, with an odds ratio increase for the Fever + 1 definition that was about twofold larger than the Fever definition. CONCLUSION: As the Fever definition demonstrated increased NIO risk for ACCA versus non-ACCA patients, the Fever alone ACCA definition should be used to trigger future clinical treatment in many clinical situations. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Molly K Gibson; Bin Wang; Sara Ahmadi; Carey-Ann D Burnham; Phillip I Tarr; Barbara B Warner; Gautam Dantas Journal: Nat Microbiol Date: 2016-03-07 Impact factor: 17.745
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