title: Perinatal inflammation/infection and its association with correction of metabolic acidosis in hypoxic-ischemic encephalopathy.
abstract: To investigate the decreased response to hypothermia in neonates with hypoxic-ischemic encephalopathy (HIE) and infection, we sought to determine the association of fetal inflammation/infection with perinatal metabolic acidosis.
  
  
  
  We performed a retrospective cohort study of neonates with suspected HIE started on whole-body hypothermia within 6 h of birth that had a cord gas at delivery and placental pathology performed. Neonates were compared based on the presence of clinical and histologic chorioamnionitis. The cord gas at delivery was compared with the initial arterial gas after birth.
  
  
  
  In all, 50 out of 67 (74.6%) neonates admitted for therapeutic hypothermia met inclusion criteria. Chorioamnionitis did not affect the cord gas at delivery, but both clinical and histologic chorioamnionitis were associated with a significantly increased metabolic acidosis on the initial neonatal arterial gas.
  
  
  
  Chorioamnionitis, diagnosed both clinically and histologically, is associated with a persistent state of acidosis in neonates with HIE that may contribute to worse neurologic outcomes.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: C T
authors.initials: CT
authors.lastname: Johnson
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Neuroscience Intensive Care Nursery Program at Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: I
authors.initials: I
authors.lastname: Burd
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: R
authors.identifier: 0000-0001-8401-0051
authors.initials: R
authors.lastname: Raghunathan
authors.affiliation: Neuroscience Intensive Care Nursery Program at Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Department of Pediatrics, Division of Neonatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: F J
authors.initials: FJ
authors.lastname: Northington
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Neuroscience Intensive Care Nursery Program at Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Graham
mesh_terms: D000138:Acidosis / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D002821:Chorioamnionitis / Q000473:pathology; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000379:methods; D020925:Hypoxia-Ischemia, Brain / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D007231:Infant, Newborn; D007239:Infections / Q000175:diagnosis / Q000209:etiology; D007249:Inflammation / Q000175:diagnosis / Q000209:etiology; D009422:Nervous System Diseases / Q000209:etiology / Q000517:prevention & control*; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome