title: Chorioamnionitis and neonatal outcome in preterm infants: a clinical overview.
abstract: The term chorioamnionitis is used to refer to an intrauterine infection/inflammation occurring between the maternal tissues and the fetal membranes (choriodecidual space) or in the fetal annexes (chorioamniotic membranes, amniotic fluid, umbilical cord). Histological examination of the placenta is the gold standard for diagnosis. However, clinical, biochemical and microbiological criteria are also used to define the disease. The literature contains a large body of evidence showing that chorioamnionitis is the leading cause of very preterm birth and, therefore, contributes significantly to neonatal morbidity and mortality. In recent decades, numerous studies have attempted to establish whether, and to what extent, intrauterine infection/inflammation might negatively affect the short- and long-term outcome of preterm infants. The question is still unanswered. The discrepancy observed across studies can be attributed largely to the use of different inclusion and exclusion criteria, diagnostic criteria and methods, and to whether or not potential confounding factors, such as gestational age were considered. Anyhow, the association between chorioamnionitis and severe prematurity requires serious efforts by researchers to clarify the mechanisms linking intrauterine infection/inflammation with preterm birth, and thus to identify strategies that may guide clinicians' diagnostic and therapeutic choices, with regard to both mothers and infants.
authors.affiliation: a Department of Clinical Sciences and Community Health , NICU .
authors.forename: Lorenza
authors.initials: L
authors.lastname: Pugni
authors.affiliation: a Department of Clinical Sciences and Community Health , NICU .
authors.forename: Carlo
authors.initials: C
authors.lastname: Pietrasanta
authors.affiliation: b Department of Obstetrics and Gynecology , and.
authors.forename: Barbara
authors.initials: B
authors.lastname: Acaia
authors.affiliation: c Department of Pathophysiology and Organ Transplantation, Division of Pathology , Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan , Milan , Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Merlo
authors.affiliation: a Department of Clinical Sciences and Community Health , NICU .
authors.forename: Andrea
authors.initials: A
authors.lastname: Ronchi
authors.affiliation: b Department of Obstetrics and Gynecology , and.
authors.forename: Manuela Wally
authors.initials: MW
authors.lastname: Ossola
authors.affiliation: c Department of Pathophysiology and Organ Transplantation, Division of Pathology , Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan , Milan , Italy.
authors.forename: Silvano
authors.initials: S
authors.lastname: Bosari
authors.affiliation: a Department of Clinical Sciences and Community Health , NICU .
authors.forename: Fabio
authors.initials: F
authors.lastname: Mosca
mesh_terms: D002821:Chorioamnionitis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018805:Sepsis / Q000453:epidemiology
keywords: Brain injury; bronchopulmonary dysplasia; death; funisitis; intrauterine inflammation; prematurity; respiratory distress syndrome; sepsis