title: Histologic chorioamnionitis, fetal involvement, and antenatal steroids: effects on neonatal outcome in preterm infants.
abstract: OBJECTIVE
  The objective of the study was to study the effects of histologic chorioamnionitis (HC) with or without fetal involvement and antenatal steroid (AS) exposure on neonatal outcome in a prospective cohort of preterm infants.
  
  
  METHODS
  The clinical characteristics and placental histology were prospectively collected in 301 infants born at a gestational age 32.0 weeks or less in the Erasmus University Medical Center.
  
  
  RESULTS
  In univariable analyses, HC without fetal involvement (n=53) was associated with decreased severe respiratory distress syndrome (RDS) (11% vs 28%; P<.05), whereas HC with fetal involvement infants (n=68) had more necrotizing enterocolitis (9% vs 2%; P<.05), intraventricular hemorrhage (IVH) (25% vs 12%; P<.05), and neonatal mortality (19% vs 9%; P<.05). In HC without fetal involvement infants, AS reduced the incidences of RDS (43% vs 85%; P<.05) and IVH (5% vs 39%; P<.01). In multivariable analyses, HC without fetal involvement was associated with decreased severe RDS (odds ratio, 0.22; 95% confidence interval, 0.05-0.93; P<.05) and increased early-onset sepsis (odds ratio, 2.22; 95% confidence interval, 1.02-4.83; P<.05).
  
  
  CONCLUSIONS
  In a prospective cohort of preterm infants, multivariable analyses reveal only a modest association between histologic chorioamnionitis and neonatal outcome.
authors.affiliation: Department of Pediatrics, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Jasper V
authors.initials: JV
authors.lastname: Been
authors.forename: Ingrid G I J G
authors.initials: IG
authors.lastname: Rours
authors.forename: René F
authors.initials: RF
authors.lastname: Kornelisse
authors.forename: Valéria
authors.initials: V
authors.lastname: Lima Passos
authors.forename: Boris W
authors.initials: BW
authors.lastname: Kramer
authors.forename: Tom A J
authors.initials: TA
authors.lastname: Schneider
authors.forename: Ronald R
authors.initials: RR
authors.lastname: de Krijger
authors.forename: Luc J I
authors.initials: LJ
authors.lastname: Zimmermann
mesh_terms: D000328:Adult; D002821:Chorioamnionitis / Q000473:pathology*; D005260:Female; D005333:Fetus / Q000187:drug effects* / Q000473:pathology; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D047928:Premature Birth; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids