The Relationship between Histological Chorioamnionitis and Bronchopulmonary Dysplasia in Low-Birth Weight Infants: Changes of C-Reactive Protein in Bronchopulmonary Dysplasia

Abstract

Objective: Intrauterine inflammation caused by chorioamnionitis has been related with various perinatal morbidities which increase the risk of bronchopulmonary dysplasia (BPD). C-reactive protein (CRP) is a well known biomarker of inflammation. We aimed to investigate the relationship between histological chorioamnionitis (HCA) and BPD, and also to observe the changes of CRP in BPD. Methods: Low-birth-weight infants (LBWIs) admitted to the neonatal intensive care unit between January 2011 and October 2017 were reviewed. Perinatal morbidities associated with BPD including maternal HCA were observed. Also, changes of CRP were analyzed. Results: A total of 584 LBWIs were analyzed and 168 (28.8%) had HCA and 46 (7.9%) had BPD. The development of BPD was associated with gestational age, birth weight, 1 and 5 minutes Apgar scores, the presence of preterm premature rupture of membrane, prenatal antibiotics, respiratory distress syndrome (RDS), ventilator application, early onset sepsis, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, patent ductus arteriosus and HCA. The multiple logistic regression model for BPD showed that the risk factors of BPD were lower gestational age, lower birth weight, patent ductus arteriosus (PDA). Chorioamnionitis was not a significant risk factor for BPD (aOR, 1.477; 95% CI, 0.376-5.806). Infants with BPD were likely to have higher CRP on day 0 and day 7. Conclusion: Our study suggests that the primary risk factors of BPD in LBWIs are lower gestational age, lower birth weight, RDS, ventilator application and PDA rather than HCA. In infants with BPD, CRP was significantly higher on day 0 and day 7.