title: Silent chorioamnionitis and associated pregnancy outcomes: a review of clinical data gathered over a 16-year period.
abstract: OBJECTIVE
  To assess neonatal outcomes and associated findings in pregnant women identified after delivery as having had underlying subclinical chorioamnionitis by either histology or bacterial culture.
  
  
  METHODS
  In 16 years, 8974 clinical, histological, and bacterial culture data were obtained retrospectively.
  
  
  RESULTS
  Placental histology was analyzed in 4237 pregnancies (2785 term and 1452 preterm) and 4737 amniotic cavity cultures were obtained during 5446 cesarean deliveries (3268 term and 1469 preterm). Histological results and bacterial cultures were both available in 1270 of the preterm deliveries. Histology revealed inflammation, suggestive of infection, in 13.6% of placentas. Subclinical acute chorioamnionic inflammation was confirmed in 142 out of 2785 term pregnancies (5.1%) and in 436 out of 1452 preterm pregnancies (30.0%, P<0.001). Bacteriological culture of the intrauterine cavity was obtained from the lower uterine segment of the uterus during cesarean section. A positive culture was found in 19.9% of all cases (941/4737), this proportion was significantly higher in preterm deliveries (343/1273, 26.9%) than in term (17.3%, P<0.001). The lower the birth-weight or gestational age, the higher the frequency of silent infections in the uterine cavity.
  
  
  CONCLUSIONS
  Our study findings support the association between intra-amniotic infections and preterm delivery.
authors.forename: Boldizsár
authors.initials: B
authors.lastname: Horvath
authors.forename: Ferenc
authors.initials: F
authors.lastname: Lakatos
authors.forename: Csaba
authors.initials: C
authors.lastname: Tóth
authors.forename: Tamás
authors.initials: T
authors.lastname: Bödecs
authors.forename: József
authors.initials: J
authors.lastname: Bódis
mesh_terms: D000650:Amnion / Q000382:microbiology; D001724:Birth Weight; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000175:diagnosis*; D005321:Extraembryonic Membranes / Q000473:pathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D010920:Placenta / Q000382:microbiology / Q000473:pathology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D014470:Umbilical Cord / Q000473:pathology; D014599:Uterus / Q000382:microbiology