Chorioamnionitis and lung damage in the extremely low birth weight infant

Abstract

Some experimental work suggests that exposure to intrauterine infection is associated, not only, with lung maturation and a reduced risk of respiratory distress syndrome, but also, with delayed alveolarization and increased risk of bronchopulmonary dysplasia. AimTo evaluate the association between histological chorioamnionitis and lung disease in extremely low birth weight preterm infants. MethodsA retrospective chart review of 63 less than 1000g birthweight, appropriated for gestational age neonates, delivered at three tertiary medical centers in the north of Portugal, between 2001 and 2002. The association between histological chorioamnionitis and lung damage (respiratory distress syndrome and bronchopulmonary dysplasia) was evaluated through the calculation of crude and adjusted odds ratio. ResultsThere were 32 newborns from mothers with histological chorioamnionitis and 31 without the condition. The association between histological chorioamnionitis and respiratory distress syndrome was OR 0.23 (95% CI 0.01 – 2.51). The association between chorioamnionitis and bronchopulmonary dysplasia was OR 1.61 (95% CI 0.38 – 6.97). The association between histological chorioamnionitis and bronchopulmonary dysplasia when adjusted for gestational age, multiple birth and C-section revealed no statistical significance: OR 2.66 (95% CI 0.36 – 19.60) for chorioamnionitis without funisitis or vasculitis and OR 1.68 (95% CI 0.25 – 11.18) for funisitis and/or vasculitis. ConclusionIn this study we could not confirm a decreased risk of respiratory distress syndrome nor an increased risk of bronchopulmonary dysplasia in extremely low birth weight preterm neonates with histological chorioamnionitis.