title: [Chorioamnionitis and neonatal morbidity].
abstract: BACKGROUND
  Several studies highlight the association between perinatal infection/inflammation and neonatal morbidity, mainly bronchopulmonary dysplasia and periventricular leukomalacia.
  
  
  OBJECTIVE
  To evaluate the role of histological chorioamnionitis on the overall morbidity of preterm newborns.
  
  
  METHODS
  A retrospective study on preterm newborns less than 34 weeks gestational age at birth, and respective mothers, at three tertiary medical centers (Hospital de São João, Maternidade Júlio Dinis and Centro Hospitalar de Vila Nova de Gaia) in the north of Portugal, between January 2001 and December 2002. We evaluated the association between histological chorioamnionitis and the overall neonatal morbidity. The association between histological chorioamnionitis and acute (respiratory distress syndrome) and chronic (bronchopulmonary dysplasia) lung damage was also evaluated in the subgroup of less than 1000 g birthweight preterm neonates.
  
  
  RESULTS
  452 [ M 253 / F 217; birthweight 1440 (515-2620) g; gestational age 31 (23-33) weeks] preterm newborns were included. The association between histological chorioamnionitis and the overall neonatal morbidity was: respiratory distress syndrome OR 1.5 (95% CI 0.94-2.31); bronchopulmonary dysplasia OR 2.6 (95% CI 1.16-6.03); patent ductus arteriosus OR 2.5 (95% CI 1.17-5.44); sepsis OR 1.2 (95% CI 0.9-2.13); necrotizing enterocolitis OR 1.4 (95% CI 0.9-1.76); intraventricular hemorrhage grades III-IV OR 2.5 (1.20-5.11); cystic periventricular leukomalacia OR 3.0 (1.5-6.07); retinopathy of prematurity OR 1.4 (95% CI 0.8-1.35). The association adjusted to birthweight and gestational age was: bronchopulmonary dysplasia OR 1.2 (95% CI 0.51-2.95); patent ductus arteriosus OR 0.9 (95% CI 0.4-2.35); intraventricular hemorrhage grades III-IV OR 0.9 (95% CI 0.39-2.28); cystic periventricular leukomalacia OR 2.2 (95% CI 1.03-4.61). The association between histological chorioamnionitis and lung damage in the subgroup of less than 1000 g birthweight preterm neonates was: respiratory distress syndrome OR 0.23 (95% CI 0.01-2.51); bronchopulmonary dysplasia OR 1.61 (95% CI 0.38-6.97).
  
  
  CONCLUSIONS
  This study confirms the association between histological chorioamnionitis and cystic periventricular leukomalacia of the preterm newborn.
authors.affiliation: Serviço de Neonatologia, Departamento de Pediatria, Hospital de São João, Porto.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rocha
authors.forename: Elisa
authors.initials: E
authors.lastname: Proença
authors.forename: Conceição
authors.initials: C
authors.lastname: Quintas
authors.forename: Teresa
authors.initials: T
authors.lastname: Rodrigues
authors.forename: Hercília
authors.initials: H
authors.lastname: Guimarães
mesh_terms: D002821:Chorioamnionitis / Q000473:pathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D011247:Pregnancy; D012189:Retrospective Studies