433 Maternal Chorioamnionitis and Its Impact on Early Morbidity of Very Low Birth Weight Infants

Abstract

Objective: To evaluate the impact of chorioamnionitis on early morbidity in very low birth weight infants (VLBW) in a retrospective study. Methods: 245 VLBW were admitted at the Neonatology Department within the years 2007- 2009. The placentas were examined histologically for the presence of acute chorioamnionitis in deliveries of 215 VLBW who were eligible for the study. The incidence of bronchopulmonary dysplasia grade 2 (BPD2), disorders of gastrointestinal tract (necrotizing enterocolitis, malabsorption syndrome, ileus of prematurity) and brain injury (intraventricular haemorrhage grade III, periventricular leucomalacia, and posthaemorrhagic hydrocephalus) was compared statistically in subgroups with proven chorioamnionitis and without it. Results: The group included 215 subjects in total, 110 (51,5%) male and 105 (48,8%) female, with mean birth weight 1069g (range 405-1490g), mean gestational age 28,5 weeks (range 23-36 wks). There were no significant differences in gestational age and birth weight between the subgroups. 167 (77.7%) deliveries was by Caesarean section. Premature rupture of membrane was found in 59 cases (27,4%) with mean latency period 28 hours (range 2-624hrs). Placental and membranes inflammation was found in 40 (18,6%) placental samples. The incidence of BPD2 was significantly elevated in the subgroup with chorioamnioitis compared to the subgroup without chorioamnioitis (OR= 3,9652, CI 95% 1,8251-8,6149). There were no significant differences regarding brain injury, gastrointestinal complications and death between the subgroups. Conclusion: This study adds further evidence that choriamnionitis may lead to higher incidence of BPD2 in preterm VLBW infants.