Abstract
BackgroundThe objective of this study was to determine whether acute histologic chorioamnionitis is associated with adverse neonatal outcomes in late preterm infants who were born after preterm PROM.Methodology/Principal FindingsThe relationship between the presence of acute histologic chorioamnionitis and adverse neonatal outcome was examined in patients with preterm PROM who delivered singleton preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Nonparametric statistics were used for data analysis. The frequency of acute histologic chorioamnionitis was 24% in patients with preterm PROM who delivered preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Newborns born to mothers with histologic chorioamnionitis had significantly higher rates of adverse neonatal outcome (74% vs 51%; p<0.005) than those without histologic chorioamnionitis. This relationship remained significant after adjustment for gestational age at preterm PROM, gestational age at delivery, and exposure to antenatal corticosteroids.Conclusions/SignificanceThe presence of acute histologic chorioamnionitis is associated with adverse neonatal outcome in late preterm infants born to mothers with preterm PROM.
Highlights
The rate of preterm deliveries rose steadily in recent years, from 9.4% in 1981 to 12.8% in 2006 according to the vital statistics in USA [1,2,3], and late preterm birth (34–36 6/7 weeks) represents 74% of all preterm deliveries [2]
Clinical characteristics and pregnancy outcomes Acute histologic chorioamnionitis and funisitis were diagnosed in 24% (58/244) and 10% (25/244) of cases, respectively
In late preterm infants who were born after preterm premature rupture of membranes (PROM); 2) The presence of acute histologic chorioamnionitis was a risk factor for the subsequent development of adverse neonatal outcome even
Summary
The rate of preterm deliveries rose steadily in recent years, from 9.4% in 1981 to 12.8% in 2006 according to the vital statistics in USA [1,2,3], and late preterm birth (34–36 6/7 weeks) represents 74% of all preterm deliveries [2]. There is increasing concern on long-term medical and behavioral morbidity, such as cerebral palsy, attention problems, antisocial behavior, and impaired cognitive and academic performances at school age [21,22,23,24,25,26]. With these evidences, Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Human workshop stressed the importance of late preterm birth and called for increased research regarding the risk factors for short- and long-term morbidity for these late preterm infants [27].
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