87: Which factor affect the occurrence of cerebral lesions in neonates born with intrauterine infection?

Abstract

BORN WITH INTRAUTERINE INFECTION? ANNA LOCATELLI, MARIANNA ANDREANI, FRANCESCA ASSI, AGNESE PIZZARDI, SILVIA MALGUZZI, ALESSANDRO GHIDINI, University of Milano-Bicocca, Obstetrics and Gynecology, Monza, Italy, University of Milano-Bicocca, Neonatology, Monza, Italy OBJECTIVE: Intrauterine infection (II) is a risk factor for cerebral lesions (CL), and part of the damage seems to be attributed to the immune fetal response. We have evaluated which factor have an effect on neonatal ultrasonographic (US) evidence of CL in the presence of histological or clinical evidence of II. STUDY DESIGN: From a cohort of 567 consecutive singleton neonates born after preterm delivery at 24.0-31.6 weeks from 1/1993 to 12/2006 we selected 180 infants with histological and/or clinical evidence of II. Obstetric (gestational age, pregnancy complications, use of steroids and antibiotic, fetal distress, mode of delivery) and neonatal (sex, weight, Apgar score, pH, neonatal complications) were evaluated in reference to evidence of neonatal severe US CL, defined as IVH grade 3-4 and/or PVL. Excluded were stillbirths and congenital anomalies. Logistic regression analysis was used to control for confounders with P 0.05 considered significant. RESULTS: Table 1 Logistic regression analysis demonstrated that evidence of neonatal severe US CL is independently associated with antenatal administration of corticosteroids (OR 0.3, 95% CI 0.11, 0.88, P 0.03) and occurrence of abruptio placentae (OR 5.4, 95% CI 1.4, 20.7, P 0.02)