Intra-amniotic inflammatory complications in preterm prelabor rupture of membranes and long-term neurodevelopmental outcomes of infants: a systematic review

J Matern Fetal Neonatal Med. 2022 Dec;35(25):5993-5998. doi: 10.1080/14767058.2021.1903859. Epub 2021 Mar 29.

Abstract

Objective: To perform a systematic review of the literature available on the association between the presence of microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation and long-term neurodevelopmental outcomes of infants from pregnancies complicated by preterm prelabor rupture of membranes (PPROM).

Methods: A literature search, from their earliest entries to May 2020, was performed by employing three electronic databases (Web of Science, PubMed, and Scopus). The selection criteria were as follows: (1) singleton pregnancies with PPROM; (2) available information regarding MIAC and/or intra-amniotic inflammation; (3) long-term (at least one year of the corrected age) neurodevelopmental outcomes of respective infants.

Results: The initial search identified 10,953 articles, of which 8 were selected for full-text reading; however, none were included in the review owing to the following reasons: (i) spontaneous preterm labor with intact membranes and/or indicated (iatrogenic) preterm delivery were included in the studies without providing separate data for PPROM (n = 5); (ii) long-term, at least one year of the corrected age, neurodevelopmental outcomes of infants were not assessed (n = 1); (iii) the presence of both the abovementioned reasons (n = 1); (iv) amniotic fluid was not assessed, and a long-term neurodevelopmental outcome was not evaluated (n = 1).

Conclusion: The literature search provides evidence of a knowledge gap in the association between the presence of MIAC and/or intra-amniotic inflammation and long-term neurodevelopmental outcomes in infants with PPROM.

Keywords: Amniocentesis; cerebral palsy; cognitive; intra-amniotic inflammation; microbial invasion of the amniotic cavity; morbidity; neurodevelopment; preterm labor; psycho-motoric.

Publication types

  • Systematic Review

MeSH terms

  • Amniotic Fluid
  • Chorioamnionitis* / etiology
  • Female
  • Fetal Membranes, Premature Rupture*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Inflammation / complications
  • Pregnancy

Supplementary concepts

  • Preterm Premature Rupture of the Membranes