Is Chorioamnionitis a Risk Factor for the Development of Necrotizing Enterocolitis?

Abstract

INTRODUCTION: We sought to determine whether the diagnosis of maternal chorioamnionitis is a risk factor for the subsequent development of neonatal necrotizing enterocolitis (NEC). METHODS: We performed a retrospective case–control study of all neonates diagnosed with NEC at our institution between 2009 and 2012. Patients with NEC were identified from an existing neonatal intensive care unit database and were control-matched with the next consecutive singleton neonate born at the same gestational age. The medical records of the neonates and the neonate's mother were reviewed. Maternal and perinatal data, including age, body mass index, hypertension, smoking status, Apgar scores, and types of neonatal feeding, were examined. Our primary outcome was incidence of chorioamnionitis in our exposure and control population. A P value of <.05 was considered significant. RESULTS: A total of 26 neonates were diagnosed with NEC and 26 matched neonates in a control group was identified. Women in our comparison groups were similar in terms of demographic characteristics including age, race, and body mass index. The prevalence of comorbid conditions such as preeclampsia, tobacco use, and preterm rupture of membranes were also similar. Additionally, the gestational ages, birth weights, and Apgar scores, sex, and mode of feeding of neonates with NEC and those without NEC were similar. Neonates whose mothers had been treated for chorioamnionitis had an increased risk (odds ratio 1.8, 95% confidence interval 0.6–5.3, P=.3) for the subsequent development of NEC; however, these results were not statistically significant (Table 1).CONCLUSION: Our data failed to show a statistically significant association between chorioamnionitis and development of NEC.