Chorioamnionitis with a fetal inflammatory response is associated with higher neonatal mortality, morbidity, and resource use than chorioamnionitis displaying a maternal inflammatory response only.
OBJECTIVE
This study was undertaken to evaluate whether the proximity of infection of the chorion/amnion and fetal vessels affects neonatal outcomes.


METHODS
We examined all (n=2012) infants admitted to the British Columbia's Children's Hospital Neonatal Intensive Care Unit, from January 1996 to October 1997. We included infants with a placental examination (n=1296), and stratified those with histologic chorioamnionitis into cases displaying a maternal inflammatory response only and cases also displaying a fetal inflammatory response (funisitis and/or fetal surface vessel angiitis).


RESULTS
Histologic evidence of chorioamnionitis was present in 31% of placentas. Of those, 38% exhibited maternal inflammation only, whereas 62% also exhibited fetal inflammation. Neonatal mortality (9.2% vs 7.2%), morbidity, and resource use were significantly (P < .05) higher when fetal inflammation was present compared with when only maternal inflammation was present.


CONCLUSIONS
Chorioamnionitis with a fetal inflammatory response is associated with higher neonatal mortality, morbidity, and resource use than when only a maternal inflammatory response is present.
Lau
Jacqueline
J
Centre for Healthcare Innovation and Improvement, School of Medicine, Queen's University, Vancouver, British Columbia, Canada.
Magee
Fergall
F
Qiu
Zhenguo
Z
Houbé
Jill
J
Von Dadelszen
Peter
P
Lee
Shoo K
SK
D002821:Chorioamnionitis / Q000401:mortality* / Q000473:pathology*; D005260:Female; D005333:Fetus / Q000473:pathology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009017:Morbidity; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D012307:Risk Factors