title: Chorioamnionitis and Five-Year Neurodevelopmental Outcome in Preterm Infants.
abstract: Chorioamnionitis, a risk factor for preterm delivery, has been suggested to be associated with suboptimal neurological development in premature infants.
  
  
  
  To evaluate the association between chorioamnionitis and neurodevelopment in preterm infants at 5 years of age. Methods Very low birth weight and very low gestational age infants (n = 197) were recruited. Placental samples (n = 117) were evaluated for histological chorioamnionitis. Fetal histological chorioamnionitis was analyzed as a subgroup. The diagnosis of clinical chorioamnionitis was derived from medical records. Neurodevelopmental impairments were evaluated at 2 years of age, and cognitive development (n = 188) and neuropsychological performance (n = 193) were evaluated at 5 years of age.
  
  
  
  There were no associations between histological or clinical chorioamnionitis and neurodevelopmental impairments at 2 years of age. Clinical chorioamnionitis and fetal histological chorioamnionitis were not associated with cognitive development or neuropsychological performance, but histological chorioamnionitis was associated with poorer cognitive outcome (regression coefficient = -7.22, 95% CI: -14.31 to -0.13) and weaker memory and learning functions (regression coefficient = -1.29, 95% CI: -2.40 to -0.18) at 5 years of age.
  
  
  
  Our study findings do not support clinical chorioamnionitis having a major independent role in the pathogenesis of neurodevelopmental problems in very preterm infants. Histological chorioamnionitis was associated with slightly less optimal performance at 5 years of age, but further studies are needed to verify the clinical significance of these findings.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Turku University and Turku University Hospital, Turku, Finland.
authors.forename: Milla
authors.initials: M
authors.lastname: Ylijoki
authors.forename: Liisa
authors.initials: L
authors.lastname: Lehtonen
authors.forename: Annika
authors.initials: A
authors.lastname: Lind
authors.forename: Eeva
authors.initials: E
authors.lastname: Ekholm
authors.forename: Helena
authors.initials: H
authors.lastname: Lapinleimu
authors.forename: Harry
authors.initials: H
authors.lastname: Kujari
authors.forename: Leena
authors.initials: L
authors.lastname: Haataja
mesh_terms: D002675:Child, Preschool; D002821:Chorioamnionitis / Q000473:pathology*; D003071:Cognition; D002658:Developmental Disabilities / Q000175:diagnosis; D005260:Female; D005387:Finland; D005865:Gestational Age; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D016015:Logistic Models; D008297:Male; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D012307:Risk Factors