title: Usefulness of two clinical chorioamnionitis definitions in predicting neonatal infectious outcomes: a systematic review.
abstract: OBJECTIVE
  To assess the usefulness of two definitions of acute clinical chorioamnionitis (ACCA) in predicting risk of neonatal infectious outcomes (NIO) and mortality, the first definition requiring maternal fever alone (Fever), and the second requiring ≥ 1 Gibbs criterion besides fever (Fever + 1).
  
  
  METHODS
  PubMed, Web of Science, and the Cochrane Database of Systematic Reviews were searched from January 1, 1979 to April 9, 2013. Twelve studies were reviewed (of 316 articles identified): three studies with term patients, four with preterm premature rupture of membranes (PPROM) patients, and five mixed studies with mixed gestational ages and/or membrane status (intact and/or ruptured).
  
  
  RESULTS
  Both definitions demonstrated an increased NIO risk for ACCA versus non-ACCA patients, with an odds ratio increase for the Fever + 1 definition that was about twofold larger than the Fever definition.
  
  
  CONCLUSIONS
  As the Fever definition demonstrated increased NIO risk for ACCA versus non-ACCA patients, the Fever alone ACCA definition should be used to trigger future clinical treatment in many clinical situations.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Avila
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Willins
authors.affiliation: U.S. Food and Drug Administration, CDER/OTS/OB/DB6, Silver Spring, Maryland.
authors.forename: Matthew
authors.initials: M
authors.lastname: Jackson
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
authors.forename: Jacob
authors.initials: J
authors.lastname: Mathai
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
authors.forename: Marina
authors.initials: M
authors.lastname: Jabsky
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
authors.forename: Alex
authors.initials: A
authors.lastname: Kong
authors.affiliation: Lister Hill Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, Maryland.
authors.forename: Fiona
authors.initials: F
authors.lastname: Callaghan
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
authors.forename: Selda
authors.initials: S
authors.lastname: Ishkin
authors.affiliation: Department of Surgery, Stony Brook University School of Medicine, Stony Brook, New York.
authors.forename: A Laurie W
authors.initials: AL
authors.lastname: Shroyer
mesh_terms: D002821:Chorioamnionitis / Q000175:diagnosis*; D005260:Female; D005334:Fever / Q000209:etiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011379:Prognosis; D018805:Sepsis / Q000150:complications*