Maternal chorioamnionitis & long term neurological morbidity in the offspring.

Abstract

Chorioamnionitis is a common and potentially devastating complication of pregnancy associated with maternal and perinatal adverse outcomes. To evaluate a possible association between maternal chorioamnionitis and long-term pediatric neurological morbidity. A population-based retrospective cohort analysis was performed comparing the risk of long-term neurological morbidity. Pediatric neurological morbidity evaluated included hospitalizations with neurological morbidity. Kaplan-Meier survival curves were constructed to compare the cumulative neurological morbidity and a Cox regression model was used to control for confounders. 238622 newborns were included. Of them, 0.5% were born to mothers with chorioamnionitis. 3.1% offspring were hospitalized with a neurological condition. Total neurological morbidity was not significantly more common in the chorioamnionitis group (3.8% vs. 3.1% respectively, OR 1.23, 95% CI 0.9-1.6, p=0.147). However, a significant and independent association was noted between maternal chorioamnionitis and cerebral palsy. (0.5% vs. 0.1%, OR 5.77, 95% CI 2.5-13.0, p=0.001). In a Cox proportional hazards model, controlling for preterm delivery, birthweight, maternal factors and mode of delivery the association between chorioamnionitis and cerebral palsy remained significant (adjusted HR=2.78, 95% CI 1.20-6.43, P=0.016). Maternal chorioamnionitis is associated with cerebral palsy in the offspring, independently of other birth circumstances such as preterm delivery and birthweight.