title: Chorioamnionitis with a fetal inflammatory response is associated with higher neonatal mortality, morbidity, and resource use than chorioamnionitis displaying a maternal inflammatory response only.
abstract: 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.
authors.affiliation: Centre for Healthcare Innovation and Improvement, School of Medicine, Queen's University, Vancouver, British Columbia, Canada.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Lau
authors.forename: Fergall
authors.initials: F
authors.lastname: Magee
authors.forename: Zhenguo
authors.initials: Z
authors.lastname: Qiu
authors.forename: Jill
authors.initials: J
authors.lastname: Houbé
authors.forename: Peter
authors.initials: P
authors.lastname: Von Dadelszen
authors.forename: Shoo K
authors.initials: SK
authors.lastname: Lee
mesh_terms: 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