title: Maternal Chorioamnionitis and Postneonatal Respiratory Tract Infection in Ex-Preterm Infants.
abstract: To assess whether exposure to histologically confirmed chorioamnionitis (ie, histologic chorioamnionitis [HCA]) is associated with altered risk of infection-related hospitalization (IRH) during the first 24 months of life in very preterm infants.
  
  
  
  This single-center retrospective cohort study analyzed data on 1218 infants born at <30 weeks gestational age (GA). Semiquantitative placental histology, obstetric, and neonatal data were extracted from hospital databases and linked with discharge diagnoses on rehospitalization until age 24 months from statewide statutory data. The associations between HCA and overall and clinical categories of IRH were analyzed by Cox proportional hazards regression with left-truncated failure times.
  
  
  
  Mean GA was 27 weeks, and HCA was present in 577 placentas (47.4%). Among the 1088 infants surviving until the birth-related discharge, 684 (62.9%) of had at least 1 IRH by age 24 months, of whom 287 included a diagnosis of acute lower respiratory tract infection (ALRTI). Following adjustment for sex, birth weight z-score, GA, early-onset sepsis, late-onset sepsis, previous antibiotic use, age at birth-related discharge, and chronic lung disease, HCA was associated with a 32% increased risk of hospitalization with ALRTI (HR, 1.32; 95% CI, 1.02-1.70; P = .033). There was no association with infection overall or with other infection categories.
  
  
  
  HCA is associated with a significantly increased risk of hospitalization with ALRTI that is independent of known risk factors, including chronic lung disease.
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Australia; Department of Paediatrics, Monash University, Australia; Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Australia. Electronic address: david.burgner@mcri.edu.au.
authors.forename: David P
authors.initials: DP
authors.lastname: Burgner
authors.affiliation: School of Women's and Infants' Health, University of Western Australia, Australia; Women and Infants Research Foundation, Perth, Australia.
authors.forename: Dorota
authors.initials: D
authors.lastname: Doherty
authors.affiliation: Women and Infants Research Foundation, Perth, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Humphreys
authors.affiliation: Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Australia; Molecular and Biomedical Sciences, Murdoch University, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Currie
authors.affiliation: Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Australia; Neonatal Clinical Care Unit, King Edward Memorial and Princess Margaret Hospitals, Subiaco, WA.
authors.forename: Karen
authors.initials: K
authors.lastname: Simmer
authors.affiliation: Department of Pathology, Sidra Medical and Research Center, Doha, Qatar.
authors.forename: Adrian
authors.initials: A
authors.lastname: Charles
authors.affiliation: Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Australia; Neonatal Clinical Care Unit, King Edward Memorial and Princess Margaret Hospitals, Subiaco, WA.
authors.forename: Tobias
authors.initials: T
authors.lastname: Strunk
mesh_terms: D002675:Child, Preschool; D002821:Chorioamnionitis; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature; D008297:Male; D011247:Pregnancy; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012189:Retrospective Studies
keywords: histologic chorioamnionitis; infection-related hospitalization; preterm infant