Chorioamnionitis and brain damage in the preterm newborn.
OBJECTIVE
To evaluate the association between histological chorioamnionitis and brain damage (intraventricular hemorrhage and cystic periventricular leukomalacia) in the preterm newborn.


METHODS
This was a retrospective study on neonates born at less than 34 weeks gestational age, and their respective mothers, at three tertiary medical centers in the north of Portugal, from January 2001 to December 2002.


RESULTS
The study included 452 newborns (235 male/217 female; birth weight 1440 (515-2620) grams; gestational age 31 (23-33) weeks), 125 from mothers whose placenta showed signs of chorioamnionitis and 327 from mothers without the condition. The association between histological chorioamnionitis and: (1) intraventricular hemorrhage grades I-IV was OR 1.43 (95% CI 0.49-3.94); (2) intraventricular hemorrhage grades III and IV was OR 2.49 (95% CI 1.20-5.11); (3) cystic periventricular leukomalacia was OR 3.02 (95% CI 1.50-6.07). The association, adjusted for birth weight and gestational age, between chorioamnionitis and: (1) intraventricular hemorrhage grades III and IV was OR 0.94 (95% CI 0.39-2.28); (2) cystic periventricular leukomalacia was OR 1.94 (95% CI 1.03-4.61). The association between histological chorioamnionitis with funisitis and/or vasculitis and: (1) intraventricular hemorrhage grades I to IV was OR 1.27 (95% CI 0.52-3.10); (2) cystic periventricular leukomalacia was OR 2.08 (95% CI 0.72-5.98).


CONCLUSIONS
This study confirms the association between histological chorioamnionitis and cystic periventricular leukomalacia, but was unable to confirm the association between histological chorioamnionitis and intraventricular hemorrhage.
Rocha
Gustavo
G
Pediatric Department, Division of Neonatology, Hospital de São João, University Hospital, Porto, Portugal. gusrocha@oninet.pt
Proença
Elisa
E
Quintas
Conceição
C
Rodrigues
Teresa
T
Guimarães
Hercília
H
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000150:complications*; D002552:Cerebral Ventricles / Q000293:injuries; D002821:Chorioamnionitis / Q000473:pathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000150:complications*; D008297:Male; D011247:Pregnancy; D047928:Premature Birth; D012189:Retrospective Studies