title: Pulmonary Morbidity in Infancy after Exposure to Chorioamnionitis in Late Preterm Infants.
abstract: Chorioamnionitis is an important cause of preterm birth, but its impact on postnatal outcomes is understudied.
  
  
  
  To evaluate whether fetal exposure to inflammation is associated with adverse pulmonary outcomes at 6 to 12 months' chronological age in infants born moderate to late preterm.
  
  
  
  Infants born between 32 and 36 weeks' gestational age were prospectively recruited (N = 184). Chorioamnionitis was diagnosed by placenta and umbilical cord histology. Select cytokines were measured in samples of cord blood. Validated pulmonary questionnaires were administered (n = 184), and infant pulmonary function testing was performed (n = 69) between 6 and 12 months' chronological age by the raised volume rapid thoracoabdominal compression technique.
  
  
  
  A total of 25% of participants had chorioamnionitis. Although infant pulmonary function testing variables were lower in infants born preterm compared with historical normative data for term infants, there were no differences between infants with chorioamnionitis (n = 20) and those without (n = 49). Boys and black infants had lower infant pulmonary function testing measurements than girls and white infants, respectively. Chorioamnionitis exposure was associated independently with wheeze (odds ratio [OR], 2.08) and respiratory-related physician visits (OR, 3.18) in the first year of life. Infants exposed to severe chorioamnionitis had increased levels of cord blood IL-6 and greater pulmonary morbidity at age 6 to 12 months than those exposed to mild chorioamnionitis. Elevated IL-6 was associated with significantly more respiratory problems (OR, 3.23).
  
  
  
  In infants born moderate or late preterm, elevated cord blood IL-6 and exposure to histologically identified chorioamnionitis was associated with respiratory morbidity during infancy without significant changes in infant pulmonary function testing measurements. Black compared with white and boy compared with girl infants had lower infant pulmonary function testing measurements and worse pulmonary outcomes.
authors.affiliation: 1 Division of Pulmonary Medicine.
authors.forename: Karen M
authors.initials: KM
authors.lastname: McDowell
authors.affiliation: 2 Division of Neonatology.|3 Division of Pulmonary Biology.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Jobe
authors.affiliation: 1 Division of Pulmonary Medicine.|4 Division of Epidemiology and Biostatistics, and.
authors.forename: Matthew
authors.initials: M
authors.lastname: Fenchel
authors.affiliation: 1 Division of Pulmonary Medicine.
authors.forename: William D
authors.initials: WD
authors.lastname: Hardie
authors.affiliation: 2 Division of Neonatology.|3 Division of Pulmonary Biology.
authors.forename: Tate
authors.initials: T
authors.lastname: Gisslen
authors.affiliation: 1 Division of Pulmonary Medicine.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Young
authors.affiliation: 5 Division of Molecular Immunology, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine, Cincinnati, Ohio; and.
authors.forename: Claire A
authors.initials: CA
authors.lastname: Chougnet
authors.affiliation: 6 Section of Pediatric Pulmonology, Allergy, and Sleep Medicine, Riley Hospital for Children, Indiana University School of Medicine, Indiana University, Indianapolis, Indiana.
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Davis
authors.affiliation: 2 Division of Neonatology.|3 Division of Pulmonary Biology.
authors.forename: Suhas G
authors.initials: SG
authors.lastname: Kallapur
mesh_terms: D000328:Adult; D044383:Black People / Q000706:statistics & numerical data; D002821:Chorioamnionitis / Q000503:physiopathology*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D015850:Interleukin-6 / Q000097:blood*; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology*; D008297:Male; D015999:Multivariate Analysis; D009820:Ohio; D011247:Pregnancy; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000209:etiology; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult; D001741:Black or African American
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6
keywords: asthma; fetal inflammation; fetal programming; infant pulmonary function test; wheeze