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J Pediatr. 2002 Feb;140(2):171-6.

Chorioamnionitis, mechanical ventilation, and postnatal sepsis as modulators of chronic lung disease in preterm infants.

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1
Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Abstract

OBJECTIVE:

This case-control study of chronic lung disease (CLD) evaluated the hypothesis that chorioamnionitis promotes CLD and interacts with other risk factors for CLD, including mechanical ventilation and postnatal infection.

STUDY DESIGN:

We identified a population of 193 infants who met our case criteria for CLD whose birth weights were <or=1500 g. These infants were matched 1:1 with control infants for gestational age and hospital of birth.

RESULTS:

Univariable analyses revealed decreased CLD risk associated with histologic chorioamnionitis and increased risk associated with mechanical ventilation >7 days and culture-documented sepsis. In multivariable analyses, infants were at greatest risk for CLD when they had exposure to both chorioamnionitis and either mechanical ventilation >7 days (odds ratio, 3.2; 95% confidence interval, 0.9-11) or postnatal infection (odds ratio, 2.9; 95% confidence interval, 1.1-7.4).

CONCLUSIONS:

We conclude that prolonged mechanical ventilation or postnatal infection increases the risk of CLD among surviving preterm infants and that these 2 factors interact with antenatal infection to further increase the risk of CLD.

PMID:
11865267
DOI:
10.1067/mpd.2002.121381
[Indexed for MEDLINE]

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