Effect of maternal clinical chorioamnionitis on neonatal morbidity in very-low birthweight infants: a case-control study.
To assess the relationship between maternal clinical chorioamnionitis and neonatal outcome in preterm very-low birthweight (VLBW) infants.



An observational case-control study was conducted in the Neonatology Services of 12 acute-care teaching hospitals in Spain. Between January 2004 and December 2006, all consecutive VLBW (< or =1500 g) infants born to a mother with clinical chorioamnionitis were enrolled. Controls were infants without chorioamnionitis matched by gestational age who were born immediately after each index case.



There were 165 cases and 163 controls. A significantly higher percentage of cases than controls required intubation (53% vs. 35.8%), had normal intrauterine growth (98.1% vs. 84.7%), were born in a tertiary center (inborn) (95.1% vs. 89.1%), from single gestations (76.4% vs. 65.6%) and vaginal delivery (47.3% vs. 33.3%), showed a lower Apgar score at 5 min, and presented a higher rate of early-onset sepsis (10.4% vs. 1.2%). Older maternal age (32.5 vs. 30.8 years), premature labor (67.3% vs. 25.8%), premature rupture of membranes (61.3% vs. 25.8%), and antibiotic treatment (88.5% vs. 52.3%) were significantly more frequent among cases than controls.



After controlling by gestational age, maternal chorioamnionitis was associated with neonatal depression and early sepsis but not with other prematurity-related complications.
Botet
Francesc
F
Neonatology Service, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain. fbotet@clinic.ub.es
Figueras
Josep
J
Carbonell-Estrany
Xavier
X
Arca
Gemma
G
The Castrillo Study Group
D000890:Anti-Infective Agents / Q000008:administration & dosage; D001034:Apgar Score; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000503:physiopathology*; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007442:Intubation, Intratracheal; D007902:Length of Stay; D009017:Morbidity; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000628:therapy
D000890:Anti-Infective Agents