The association of histological chorioamnionitis and antenatal steroids on neonatal outcome in preterm infants born at less than thirty-four weeks' gestation.
BACKGROUND
Despite continuous research on the prevention of preterm labor, preterm delivery still occurs often. Different neonatal outcomes in association with chorioamnionitis might occur with the introduction of antenatal steroids.


OBJECTIVE
The purpose of this study was to determine the effect of chorioamnionitis on the outcome of preterm infants and the association of antenatal steroids in the presence of histological chorioamnionitis (HC).


METHODS
Two hundred and fifty-seven infants born at <34 weeks and admitted to Ewha Womans University Hospital from 2005 to 2010 were enrolled. They were divided into 2 groups, one with HC (n = 89) and the other without HC (n = 168). The clinical characteristics and outcomes of the preterm infants including sepsis, respiratory distress syndrome, intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD) were analyzed.


RESULTS
HC was associated with IVH (p = 0.019) and early-onset sepsis (p = 0.038). In the HC group, the infants exposed to antenatal steroids developed BPD less than those without steroid exposure. The duration of mechanical ventilation was significantly decreased in the group with antenatal steroids.


CONCLUSIONS
HC increased the incidence of early-onset sepsis and IVH in preterm infants of less than 34 weeks' gestation with a high odds ratio of 9.54. In the presence of HC, antenatal steroids significantly decreased the incidence of BPD.
Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea.
Hye Mi
HM
Ahn
Eun Ae
EA
Park
Su Jin
SJ
Cho
Young-Ju
YJ
Kim
Hye-Sook
HS
Park
D000328:Adult; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis / Q000209:etiology*; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D002821:Chorioamnionitis / Q000175:diagnosis / Q000209:etiology*; D015897:Comorbidity; D005260:Female; D005333:Fetus / Q000187:drug effects* / Q000473:pathology; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control*; D018805:Sepsis / Q000175:diagnosis / Q000209:etiology*
D005938:Glucocorticoids