Histological Chorioamnionitis and Lung Damage in Preterm Newborns

 

Gustavo Rocha*, Elisa Proença†, Conceição Quintas‡, Teresa Rodrigues§, Hercília Guimarães*

 

*Serviço de Neonatologia, Departamento de Pediatria, Hospital de São João, Porto, Faculdade de Medicina da Universidade do Porto; †Departamento de Pediatria, Maternidade Júlio Dinis, Porto, ‡Serviço de Neonatologia, Departamento de Pediatria, Centro Hospitalar de Vila Nova de Gaia; §Departamentos de Obstetrícia e Ginecologia e Epidemiologia, Hospital de São João, Porto, Faculdade de Medicina da Universidade do Porto

 

Introduction: Clinical and experimental data suggest that exposure to intrauterine infection is associated not only to lung maturation and reduced risk of respiratory distress syndrome, but also with delayed alveolarization and increased risk of broncopulmonary dysplasia. e aimed to evaluate the association between histological chorioamnionitis and lung disease in preterm newborns.

Methods: A retrospective study of 452 neonates less than 34 weeks gestational age, delivered at three tertiary medical centers in the north of Portugal, between 2001 and 2002. The association between histological chorioamnionitis and lung damage (respiratory distress syndrome and bronchopulmonary dysplasia) was evaluated through the calculation of odds ratio.

Results: one hundred and twenty five newborns from mothers with histological chorioamnionitis and 327 without the condition. The association between histological chorioamnionitis and respiratory distress syndrome was OR 1.5 (95% CI 0.94 - 2.31). The association between chorioamnionitis and bronchopulmonary dysplasia was OR 2.6 (95% CI 1.16 -6.03). The association between histological chorioamnionitis and bronchopulmonary dysplasia when adjusted for gestational age and small for gestational age revealed no statistical significance: OR 1.2 (95% CI 0.51 - 2.95) for any placental finding and OR 1.4 (95% CI 0.46 - 4.09) for funisitis and/ or vasculitis.

Conclusion: In this study we could not confirm a decrease of respiratory distress syndrome in neonates with histological chorioamnionitis nor an association to increased risk for bronchopulmonary dysplasia, as described in some studies.

Key-words: chorioamnionitis; bronchopulmonary dysplasia; respiratory distress syndrome.

 

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Correspondência:

Dr.Gustavo Rocha

Serviço de Neonatologia

Departamento de Pediatria

Hospital São João

Alameda Prof. Hernâni Monteiro

4200-319 Porto

e-mail: gusrocha@oninet.pt