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J Pediatr. 2017 Aug;187:98-104.e3. doi: 10.1016/j.jpeds.2017.05.019. Epub 2017 Jun 2.

Histologic Chorioamnionitis and Bronchopulmonary Dysplasia in Preterm Infants: The Epidemiologic Study on Low Gestational Ages 2 Cohort.

Author information

1
French National Institute of Health and Medical Research Joint Research Unit 1153, Epidemiology and Biostatistics, Center for Epidemiology and Statistics Sorbonne Paris Cité, Department of Risks in Pregnancy, France; Paris Descartes University, Paris, France; Neonatal Medicine and Resuscitation Service in Port-Royal, Public Assistance Hospital of Paris, Cochin Hospital, Paris, France. Electronic address: heloise.torchin@inserm.fr.
2
French National Institute of Health and Medical Research Joint Research Unit 1153, Epidemiology and Biostatistics, Center for Epidemiology and Statistics Sorbonne Paris Cité, Department of Risks in Pregnancy, France; Sorbonne Universities, University of Pierre and Marie Curie, Paris, France.
3
French National Institute of Health and Medical Research Joint Research Unit 1153, Epidemiology and Biostatistics, Center for Epidemiology and Statistics Sorbonne Paris Cité, Department of Risks in Pregnancy, France; Paris Descartes University, Paris, France; Maternité Port-Royal, Public Assistance Hospital of Paris, Cochin Hospital, Paris, France.
4
French National Institute of Health and Medical Research Joint Research Unit 1153, Epidemiology and Biostatistics, Center for Epidemiology and Statistics Sorbonne Paris Cité, Department of Risks in Pregnancy, France; Sorbonne Universities, University of Pierre and Marie Curie, Paris, France; Department of Obstetrics and Gynecology, Trousseau Hospital, Paris, France.
5
University of Lille, Regional Hospital Center of Lille, Jeanne de Flandre Hospital, Lille, France.
6
Jeanne de Flandre Hospital, Department of Neonatology Regional Hospital Center of Lille, France.
7
Jeanne de Flandre Hospital, Department of Pathology, Regional Hospital Center of Lille, France.
8
French National Institute of Health and Medical Research Joint Research Unit 1153, Epidemiology and Biostatistics, Center for Epidemiology and Statistics Sorbonne Paris Cité, Department of Risks in Pregnancy, France.
9
French National Institute of Health and Medical Research Joint Research Unit 1153, Epidemiology and Biostatistics, Center for Epidemiology and Statistics Sorbonne Paris Cité, Department of Risks in Pregnancy, France; Paris Descartes University, Paris, France; Neonatal Medicine and Resuscitation Service in Port-Royal, Public Assistance Hospital of Paris, Cochin Hospital, Paris, France.
10
French National Institute of Health and Medical Research Joint Research Unit 1153, Epidemiology and Biostatistics, Center for Epidemiology and Statistics Sorbonne Paris Cité, Department of Risks in Pregnancy, France; Paris Descartes University, Paris, France; URC - CIC P1419, France.

Abstract

OBJECTIVE:

To investigate the association between histologic chorioamnionitis (HCA) and bronchopulmonary dysplasia (BPD) in very preterm infants, both in a general population and for those born after spontaneous preterm labor and after preterm premature rupture of membranes (pPROM).

STUDY DESIGN:

This study included 2513 live born singletons delivered at 24-31 weeks of gestation from a national prospective population-based cohort of preterm births; 1731 placenta reports were available. HCA was defined as neutrophil infiltrates in the amnion, chorion of the membranes, or chorionic plate, associated or not with funisitis. The main outcome measure was moderate or severe BPD. Analyses involved logistic regressions and multiple imputation for missing data.

RESULTS:

The incidence of HCA was 28.4% overall: 38% in cases of preterm labor, 64% in cases of pPROM, and less than 5% in cases of vascular disorders. Overall, the risk of BPD after adjustment for gestational age, sex, and antenatal steroids was reduced for infants with HCA (HCA alone: aOR 0.6 [95% CI 0.4-0.9]; associated with funisitis: aOR 0.5 [95% CI 0.3-0.8]). This finding was explained by the high rate of BPD and low rate of chorioamnionitis among children with fetal growth restriction. HCA was not associated with BPD in the preterm labor (13.4% vs 8.5%; aOR 0.9; 95% CI 0.5-1.8) or in the pPROM group (12.9% vs 12.1%; aOR 0.6; 95% CI 0.3-1.3).

CONCLUSION:

In homogeneous groups of infants born after preterm labor or pPROM, HCA is not associated with BPD.

KEYWORDS:

bronchopulmonary dysplasia; chorioamnionitis; inflammation; premature birth; preterm labor; preterm premature rupture of the membranes

PMID:
28583707
DOI:
10.1016/j.jpeds.2017.05.019
[Indexed for MEDLINE]

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