title: Chorioamnionitis, mechanical ventilation, and postnatal sepsis as modulators of chronic lung disease in preterm infants.
abstract: OBJECTIVE
  This case-control study of chronic lung disease (CLD) evaluated the hypothesis that chorioamnionitis promotes CLD and interacts with other risk factors for CLD, including mechanical ventilation and postnatal infection.
  
  
  METHODS
  We identified a population of 193 infants who met our case criteria for CLD whose birth weights were <or=1500 g. These infants were matched 1:1 with control infants for gestational age and hospital of birth.
  
  
  RESULTS
  Univariable analyses revealed decreased CLD risk associated with histologic chorioamnionitis and increased risk associated with mechanical ventilation >7 days and culture-documented sepsis. In multivariable analyses, infants were at greatest risk for CLD when they had exposure to both chorioamnionitis and either mechanical ventilation >7 days (odds ratio, 3.2; 95% confidence interval, 0.9-11) or postnatal infection (odds ratio, 2.9; 95% confidence interval, 1.1-7.4).
  
  
  CONCLUSIONS
  We conclude that prolonged mechanical ventilation or postnatal infection increases the risk of CLD among surviving preterm infants and that these 2 factors interact with antenatal infection to further increase the risk of CLD.
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Van Marter
authors.forename: Olaf
authors.initials: O
authors.lastname: Dammann
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
authors.forename: Marcello
authors.initials: M
authors.lastname: Pagano
authors.forename: Marianne
authors.initials: M
authors.lastname: Moore
authors.forename: Camilia
authors.initials: C
authors.lastname: Martin
mesh_terms: D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000150:complications*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology*; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D015999:Multivariate Analysis; D010920:Placenta / Q000382:microbiology; D011247:Pregnancy; D012121:Respiration, Artificial; D018805:Sepsis / Q000150:complications; D014509:Ureaplasma / Q000302:isolation & purification