Impact of chorioamnionitis and preeclampsia on neurodevelopmental outcome in preterm infants below 32 weeks gestational age.
OBJECTIVE
Intrauterine conditions may interfere with foetal brain development. We compared the neurodevelopmental outcome between infants <32 weeks gestational age after maternal preeclampsia or chorioamnionitis and controls.


METHODS
Case-control study on infants with maternal preeclampsia, chorioamnionitis and controls (each n = 33) matched for gestational age. Neurodevelopment at 2 years was assessed with the Bayley Scales of Infant Development II.


RESULTS
A total of 99 infants were included with a median gestational age of 29 weeks (range 25-32). Median mental developmental index (MDI) was 96 in the control, 90 in the chorioamnionitis and 86 in the preeclampsia group. Preeclampsia infants had a lower MDI compared with the control group (univariate p = 0.021, multivariate p = 0.183) and with the chorioamnionitis group (univariate p = 0.242; multivariate p = 0.027). Median psychomotor index was 80.5 in the control, 80 in the preeclampsia and 85 in the chorioamnionitis group and was not different between these three groups (p > 0.05). Chorioamnionitis or preeclampsia exposure was not associated with major neurodevelopmental impairments (cerebral palsy, MDI<70, PDI<70).


CONCLUSIONS
The results of this preliminary study suggest that preeclampsia and chorioamnionitis play a relatively minor role among risk factors for adverse neurodevelopment outcome. Postnatal factors such as ventilation and bronchopulmonary dysplasia may have a greater impact on neurodevelopmental outcome.
Schlapbach
Luregn J
LJ
Department of Pediatrics, University of Bern, Switzerland.
Ersch
Jörg
J
Adams
Mark
M
Bernet
Vera
V
Bucher
Hans Ulrich
HU
Latal
Beatrice
B
D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000453:epidemiology; D002821:Chorioamnionitis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008297:Male; D015999:Multivariate Analysis; D009420:Nervous System / Q000254:growth & development; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011379:Prognosis; D011597:Psychomotor Performance