ABSTRACT
The purpose of this study was to determine the short-term outcome of newborns less
than 30 weeks gestation when there is definite placental histologic chorioamnionitis.
A retrospective analysis was performed of records of all neonates delivered at our
institution from January 1989 through January 1999. This information was retrieved
from our perinatal database and pathology database. The population was stratified
according to the presence or absence of histologic chorioamnionitis. Statistical analysis
was performed using student t-test and Mann-Whitney method. Logistic regression was used to control for potential
confounding variables. There were 392 neonates less than 30 weeks gestation delivered
during this time period. Complete placental histology was available for 342 patients
(87.4%). Histologic chorioamnionitis was identified in 140 (40.9%) cases. Those with
histologic chorioamnionitis delivered sooner (26.3 versus 27.5 weeks), were of lower
birth weight (920.1 versus 1029.8 g), and had lower 5-minute Apgarscores. Neonatal
septicaemia and pneumonia were strongly associated with underlying histologic chorioamnionitis.
There was a significant reduction in the incidence of respiratory distress syndrome
(RDS) when histologic chorioamnionitis was present. Severe histologic chorioamnionitis
increases the risk of premature delivery and is strongly associated with neonatal
sepsis. There is a significant reduction in the incidence of RDS and neonatal mortality.
KEYWORDS
Chorioamnionitis - respiratory distress syndrome - neonatal sepsis
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Eugene DempseyM.D.
Department of Neonatology, Royal Victoria Hospital
687 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1