title: Chorioamnionitis is essential in the evolution of bronchopulmonary dysplasia--the case in favour.
abstract: Bronchopulmonary dysplasia (BPD) is a major sequel of extremely premature birth. Multiple ante- and postnatal factors act in concert to injure the immature lung in the pathogenesis of the disease. Among them, chorioamnionitis--according to current evidence--plays a pivotal role. Pulmonary inflammatory processes seen in animal models of chorioamnionitis resemble those seen in premature infants who developed BPD. Chorioamnionitis can doubtlessly induce extremely preterm birth, thus contributing to a gestation-dependent risk of BPD. A gestation-independent association of chorioamnionitis with an increased risk of developing BPD has been demonstrated by a recent systematic review of clinical observational studies. Antenatal inflammation with signs of a systemic fetal response reduces the response to exogenous surfactant in infants with respiratory distress syndrome, leading to a longer need for mechanical ventilation. Moreover, chorioamnionitis increases the risk of early onset sepsis. Both mechanical ventilation and sepsis are, however, major postnatal risk factors for BPD.
authors.affiliation: Mutterhaus der Borromaeerinnen, Department of Pediatrics, Feldstr. 6, 54290 Trier, Germany. Electronic address: wolfgang.thomas@mutterhaus.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Thomas
authors.affiliation: University of Würzburg, University Children's Hospital, Josef-Schneider-Str. 2, 97080 Würzburg, Germany. Electronic address: speer_c@ukw.de.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Speer
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D002821:Chorioamnionitis / Q000473:pathology*; D005260:Female; D014943:Global Health; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012307:Risk Factors
keywords: Chronic lung disease of infancy; Fetal inflammatory response syndrome; Prematurity