Amir Freud1, Tamar Wainstock2, Eyal Sheiner3, Ron Beloosesky4, Laura Fischer5, Daniella Landau6, Asnat Walfisch3. 1. Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: amirfreud@gmail.com. 2. The Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. 3. Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. 4. Obstetrics and Gynecology Ultrasound Unit in the Department of Obstetrics and Gynecology at Rambam Health Care Campus, Israel. 5. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. 6. Department of Pediatrics, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Abstract
BACKGROUND: Chorioamnionitis is a common and potentially devastating complication of pregnancy associated with maternal and perinatal adverse outcomes. OBJECTIVE: To evaluate a possible association between maternal chorioamnionitis and long-term pediatric neurological morbidity. STUDY DESIGN: A population-based retrospective cohort analysis was performed comparing the risk of long-term neurological morbidity. Pediatric neurological morbidity evaluated included hospitalizations with neurological morbidity. Kaplan-Meier survival curves were constructed to compare the cumulative neurological morbidity and a Cox regression model was used to control for confounders. RESULTS: 238 622 newborns were included. Of them, 0.5% were born to mothers with chorioamnionitis. 3.1% offspring were hospitalized with a neurological condition. Total neurological morbidity was not significantly more common in the chorioamnionitis group (3.8% vs. 3.1% respectively, OR 1.23, 95% CI 0.9-1.6, p = 0.147). However, a significant and independent association was noted between maternal chorioamnionitis and cerebral palsy. (0.5% vs. 0.1%, OR 5.77, 95% CI 2.5-13.0, p = 0.001). In a Cox proportional hazards model, controlling for preterm delivery, birthweight, maternal factors and mode of delivery the association between chorioamnionitis and cerebral palsy remained significant (adjusted HR = 2.78, 95% CI 1.20-6.43, P = 0.016). CONCLUSION: Maternal chorioamnionitis is associated with cerebral palsy in the offspring, independently of other birth circumstances such as preterm delivery and birthweight.
BACKGROUND:Chorioamnionitis is a common and potentially devastating complication of pregnancy associated with maternal and perinatal adverse outcomes. OBJECTIVE: To evaluate a possible association between maternal chorioamnionitis and long-term pediatric neurological morbidity. STUDY DESIGN: A population-based retrospective cohort analysis was performed comparing the risk of long-term neurological morbidity. Pediatric neurological morbidity evaluated included hospitalizations with neurological morbidity. Kaplan-Meier survival curves were constructed to compare the cumulative neurological morbidity and a Cox regression model was used to control for confounders. RESULTS: 238 622 newborns were included. Of them, 0.5% were born to mothers with chorioamnionitis. 3.1% offspring were hospitalized with a neurological condition. Total neurological morbidity was not significantly more common in the chorioamnionitis group (3.8% vs. 3.1% respectively, OR 1.23, 95% CI 0.9-1.6, p = 0.147). However, a significant and independent association was noted between maternal chorioamnionitis and cerebral palsy. (0.5% vs. 0.1%, OR 5.77, 95% CI 2.5-13.0, p = 0.001). In a Cox proportional hazards model, controlling for preterm delivery, birthweight, maternal factors and mode of delivery the association between chorioamnionitis and cerebral palsy remained significant (adjusted HR = 2.78, 95% CI 1.20-6.43, P = 0.016). CONCLUSION:Maternal chorioamnionitis is associated with cerebral palsy in the offspring, independently of other birth circumstances such as preterm delivery and birthweight.
Authors: Kirsi S Oldenburg; Lauren A Eaves; Lisa Smeester; Hudson P Santos; T Michael O'Shea; Rebecca C Fry Journal: Placenta Date: 2021-06-18 Impact factor: 3.287
Authors: Roberto Romero; Percy Pacora; Juan Pedro Kusanovic; Eunjung Jung; Bogdan Panaitescu; Eli Maymon; Offer Erez; Susan Berman; David R Bryant; Nardhy Gomez-Lopez; Kevin R Theis; Gaurav Bhatti; Chong Jai Kim; Bo Hyun Yoon; Sonia S Hassan; Chaur-Dong Hsu; Lami Yeo; Ramiro Diaz-Primera; Julio Marin-Concha; Kia Lannaman; Ali Alhousseini; Hunter Gomez-Roberts; Aneesha Varrey; Angel Garcia-Sanchez; Maria Teresa Gervasi Journal: J Perinat Med Date: 2021-01-26 Impact factor: 2.716