Association of chorioamnionitis and its duration with neonatal morbidity and mortality.

Abstract

OBJECTIVE:

To investigate the association of chorioamnionitis, and secondarily its duration, on neonatal adverse outcomes for infants born <34 weeks vs. ≥34 weeks.

STUDY DESIGN:

A secondary analysis from the observational U.S. Consortium on Safe Labor Study. The exposure was chorioamnionitis, and secondarily, its estimated duration. The composite outcome included pneumonia, seizure, necrotizing enterocolitis, sepsis, periventricular/intraventricular/cerebral hemorrhage, mechanical ventilation, and neonatal death. Multivariable logistic regression with generalized estimating equations was used, stratified by gestational age at delivery.

RESULTS:

Among 221,274 deliveries, the odds of the neonatal adverse outcome <34 weeks was 2-fold higher among infants exposed to chorioamnionitis vs. those who were not (62.0 vs. 47.7%; AOR: 1.86; 95%CI: 1.25-2.75), and was ~3.5-fold higher ≥34 weeks (9.2 vs. 2.5%; AOR: 3.34; 95% CI: 2.35-4.76). The estimated duration of chorioamnionitis did not change the above associations.

CONCLUSIONS:

Chorioamnionitis was associated with an approximately 2- and 3.5-fold increased odds of neonatal adverse outcomes <34 and ≥34 weeks, respectively, regardless of its estimated duration.

• Authors: Kartik K Venkatesh, Wesley Jackson, Brenna L Hughes, Mathew M Laughon, John M Thorp, David M Stamilio
• Journal: Journal of perinatology : official journal of the California Perinatal Association (J Perinatol) Vol. 39 Issue 5 Pg. 673-682 (05 2019) ISSN: 1476-5543 [Electronic] United States
• PMID: 30723279 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, N.I.H., Intramural)

Topics

• Adult
• Chorioamnionitis (epidemiology)
• Female
• Gestational Age
• Humans
• Infant
• Infant Mortality
• Infant, Newborn
• Infant, Premature
• Infant, Premature, Diseases (epidemiology)
• Logistic Models
• Male
• Morbidity
• Multivariate Analysis
• North Carolina (epidemiology)
• Obstetric Labor Complications (epidemiology)
• Pregnancy
• Pregnancy Outcome
• Young Adult