Effect of maternal clinical chorioamnionitis on neonatal morbidity in very-low birthweight infants: a case-control study

J Perinat Med. 2010 May;38(3):269-73. doi: 10.1515/jpm.2010.029.

Abstract

Aims: To assess the relationship between maternal clinical chorioamnionitis and neonatal outcome in preterm very-low birthweight (VLBW) infants.

Methods: An observational case-control study was conducted in the Neonatology Services of 12 acute-care teaching hospitals in Spain. Between January 2004 and December 2006, all consecutive VLBW (< or =1500 g) infants born to a mother with clinical chorioamnionitis were enrolled. Controls were infants without chorioamnionitis matched by gestational age who were born immediately after each index case.

Results: There were 165 cases and 163 controls. A significantly higher percentage of cases than controls required intubation (53% vs. 35.8%), had normal intrauterine growth (98.1% vs. 84.7%), were born in a tertiary center (inborn) (95.1% vs. 89.1%), from single gestations (76.4% vs. 65.6%) and vaginal delivery (47.3% vs. 33.3%), showed a lower Apgar score at 5 min, and presented a higher rate of early-onset sepsis (10.4% vs. 1.2%). Older maternal age (32.5 vs. 30.8 years), premature labor (67.3% vs. 25.8%), premature rupture of membranes (61.3% vs. 25.8%), and antibiotic treatment (88.5% vs. 52.3%) were significantly more frequent among cases than controls.

Conclusions: After controlling by gestational age, maternal chorioamnionitis was associated with neonatal depression and early sepsis but not with other prematurity-related complications.

MeSH terms

  • Anti-Infective Agents / administration & dosage
  • Apgar Score
  • Case-Control Studies
  • Chorioamnionitis / physiopathology*
  • Female
  • Fetal Growth Retardation / epidemiology
  • Fetal Membranes, Premature Rupture / epidemiology
  • Gestational Age
  • Humans
  • Infant Mortality
  • Infant, Newborn
  • Infant, Premature, Diseases / epidemiology*
  • Infant, Very Low Birth Weight / physiology*
  • Intubation, Intratracheal
  • Length of Stay
  • Morbidity
  • Obstetric Labor, Premature / epidemiology
  • Pregnancy
  • Prospective Studies
  • Respiratory Distress Syndrome, Newborn / epidemiology
  • Respiratory Distress Syndrome, Newborn / therapy

Substances

  • Anti-Infective Agents