Is chorioamnionitis harmful for the brain of preterm infants? A clinical overview.
BACKGROUND
Chorioamnionitis is an important risk factor underlying preterm delivery, and it has also been suggested that it is associated with brain lesions and deviant neurological development in prematurely born infants.


OBJECTIVE
To evaluate the possible effects of chorioamnionitis on the brain of preterm infants.


METHODS
A systematic review.


METHODS
A systematic database search was performed to identify all original articles published until 5 October 2011 evaluating the association between histological and/or clinical chorioamnionitis and brain lesions and/or neurological development in preterm infants. Altogether, 609 potentially relevant articles were identified, of which 84 original articles were included.


RESULTS
The majority of the articles do not support the hypothesis that chorioamnionitis poses a direct risk on the central nervous system of preterm infants. The full course of antenatal steroids seems to further reduce the adverse effects of inflammation on the developing nervous system.


CONCLUSIONS
It seems that there are both benefits and risks with regard to the effects of chorioamnionitis on the brain development of preterm infants. It is plausible that inflammation enhances maturation of the preterm infant and therefore has protective effects balancing its potential harmful effects. We conclude that chorioamnionitis does not carry higher risks for the brain of preterm infants than other underlying pathologies behind preterm delivery.
Department of Pediatric Neurology, Turku University Hospital, Finland.
Milla
M
Ylijoki
Eeva
E
Ekholm
Leena
L
Haataja
Liisa
L
Lehtonen
D001921:Brain / Q000196:embryology* / Q000473:pathology; D001927:Brain Diseases / Q000209:etiology*; D002821:Chorioamnionitis / Q000503:physiopathology*; D002658:Developmental Disabilities / Q000209:etiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology*; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology