Histological chorioamnionitis and neurodevelopmental outcome in preterm infants

Journal of Perinatology, 05/11/2012

Soraisham AS et al. – Histological chorioamnionitis (HCA) is associated with increased risk of cerebral palsy at 30 to 42 months corrected age in preterm infants.

Methods

  • The study design is a retrospective cohort study with a prospective follow-up.
  • All surviving infants with birth gestational age <29 weeks, born between 2000 and 2006, who had a neurodevelopmental assessment at 30 to 42 months corrected age were included.

Results

  • Of the 384 infants, 197 (51%) were born to mothers with evidence of HCA.
  • Infants with HCA were of lower gestational age (26 weeks vs 26.6 weeks) and more likely to have intraventricular hemorrhage (27.9% vs 14.4%), periventricular leukomalacia (2.5% vs 0%) and retinopathy of prematurity stage 3 (31.4% vs 22.4%).
  • On univariate analysis, infants with HCA were more likely to have cerebral palsy (12.6% vs 6.4%, P=0.04).
  • There was no significant difference in the incidence of cognitive delay, deafness, blindness, or total major disabilities between the two groups.
  • After adjusting for perinatal variables, HCA was associated with increased risk of cerebral palsy (odds ratio (OR): 2.45; 95% confidence interval (CI) 1.11 to 5.40), but not for total major disabilities (OR: 1.22; 95% CI: 0.64 to 2.34).
  • There was a trend towards increased risk of cerebral palsy with HCA with funisitis.

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