Recurrence of clinical chorioamnionitis in subsequent pregnancies.
OBJECTIVE
To establish the role of clinical chorioamnionitis as an independent risk factor for recurrence in a subsequent pregnancy.


METHODS
This was a historical cohort study of pregnant women who had their first and second deliveries at our institution between January 1988 and May 2005. The index pregnancy was restricted to those who delivered vaginally. Data were collected from a continuously updated obstetric database and included demographic and labor characteristics and neonatal outcomes. Chorioamnionitis was diagnosed clinically.


RESULTS
The study population consisted of 23,397 women. During the index pregnancy, 10% of women developed chorioamnionitis. This group was significantly different from the rest of the cohort in terms of age, ethnicity, length of labor, epidural analgesia, use of internal monitors, and incidence of prolonged rupture of membranes. In the second pregnancy, 6% of those women again developed chorioamnionitis compared with 2% of women who did not have chorioamnionitis in the first pregnancy (odds ratio 2.93, 95% confidence interval 2.40-3.57). After adjusting for the above confounders, the increased risk of recurrence persisted (odds ratio 1.85, 95% confidence interval 1.49-2.30).


CONCLUSIONS
Women delivering vaginally who were diagnosed with chorioamnionitis during their first pregnancy are at increased risk for chorioamnionitis in a subsequent pregnancy. This supports the concept that there may be a predisposition to chorioamnionitis that should be further investigated.


METHODS
II-2.
Laibl
Vanessa R
VR
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9032, USA. Vanessa.Laibl@UTSouthwestern.edu
Sheffield
Jeanne S
JS
Roberts
Scott
S
McIntire
Donald D
DD
Wendel
George D
GD
D000328:Adult; D000367:Age Factors; D016362:Analgesia, Obstetrical; D002821:Chorioamnionitis; D005321:Extraembryonic Membranes; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D012008:Recurrence; D012307:Risk Factors