title: Impact of histological chorioamnionitis, funisitis and clinical chorioamnionitis on neurodevelopmental outcome of preterm infants.
abstract: BACKGROUND
  The role of chorioamnionitis in neurodevelopment of preterm infants is not fully understood.
  
  
  OBJECTIVE
  To examine the association between different indicators of intrauterine inflammation (clinical chorioamnionitis, histological chorioamnionitis and funisitis) and neurodevelopmental impairment in very preterm infants.
  
  
  METHODS
  Preterm infants with a birth weight of <1500 g or a gestational age of <32 weeks were included. Follow-up evaluation up to 2 years of age consisted of neurological examination, neurodevelopmental assessment and visual and audiologic tests. Outcome data were compared between the chorioamnionitis and the control groups, controlling for gestational age, birth weight and Apgar score at 5 min.
  
  
  RESULTS
  One hundred seventy-seven patients comprised the study population (mean gestational age 29±2 weeks, mean birth weight 1167±344 g). Histological chorioamnionitis was present in 49% of placentas, whereas funisitis was observed in 25%. In 57% cases clinical maternal chorioamnionitis was suspected. Follow-up was available for 130 (82%) patients. Infants with funisitis, compared with controls, had a significantly higher incidence of moderate to severe disability (18% vs 5%, OR 4.07; 95% CI 1.10-15.09).
  
  
  CONCLUSIONS
  The results of this study suggest that, unlike a broad definition of histological chorioamnionitis including inflammation of maternal or fetal placental tissues, funisitis may entail a higher risk of moderate to severe disability at 2 years of age in preterm infants.
authors.affiliation: Department of Neonatology, Sant Joan de Déu University Hospital, Barcelona, Spain. nroviragirabal@hotmail.com
authors.forename: Nuria
authors.initials: N
authors.lastname: Rovira
authors.forename: Ana
authors.initials: A
authors.lastname: Alarcon
authors.forename: Marti
authors.initials: M
authors.lastname: Iriondo
authors.forename: Margarita
authors.initials: M
authors.lastname: Ibañez
authors.forename: Pilar
authors.initials: P
authors.lastname: Poo
authors.forename: Victoria
authors.initials: V
authors.lastname: Cusi
authors.forename: Thais
authors.initials: T
authors.lastname: Agut
authors.forename: Africa
authors.initials: A
authors.lastname: Pertierra
authors.forename: Xavier
authors.initials: X
authors.lastname: Krauel
mesh_terms: D001034:Apgar Score; D002675:Child, Preschool; D002821:Chorioamnionitis / Q000503:physiopathology*; D002658:Developmental Disabilities / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000523:psychology*; D008297:Male; D009422:Nervous System Diseases / Q000150:complications* / Q000453:epidemiology; D011247:Pregnancy