<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0871-3413</journal-id>
<journal-title><![CDATA[Arquivos de Medicina]]></journal-title>
<abbrev-journal-title><![CDATA[Arq Med]]></abbrev-journal-title>
<issn>0871-3413</issn>
<publisher>
<publisher-name><![CDATA[ArquiMed - Edições Científicas AEFMUP ]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0871-34132005000100002</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Histological chorioamnionitis and lung damage in preterm newborns]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rocha]]></surname>
<given-names><![CDATA[Gustavo]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
<xref ref-type="aff" rid="A02"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Proença]]></surname>
<given-names><![CDATA[Elisa]]></given-names>
</name>
<xref ref-type="aff" rid="A03"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quintas]]></surname>
<given-names><![CDATA[Conceição]]></given-names>
</name>
<xref ref-type="aff" rid="A04"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="A05"/>
<xref ref-type="aff" rid="A06"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guimarães]]></surname>
<given-names><![CDATA[Hercília]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
</contrib-group>
<aff id="A01">
<institution><![CDATA[,Hospital de São João Departamento de Pediatria Serviço de Neonatologia]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
</aff>
<aff id="A02">
<institution><![CDATA[,Universidade do Porto Faculdade de Medicina ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="A03">
<institution><![CDATA[,Maternidade Júlio Dinis Departamento de Pediatria ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
</aff>
<aff id="A04">
<institution><![CDATA[,Centro Hospitalar de Vila Nova de Gaia Departamento de Pediatria Serviço de Neonatologia]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="A05">
<institution><![CDATA[,Hospital de São João Departamentos de Obstetrícia e Ginecologia e Epidemiologia ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
</aff>
<aff id="A06">
<institution><![CDATA[,Universidade do Porto Faculdade de Medicina ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>01</month>
<year>2005</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>01</month>
<year>2005</year>
</pub-date>
<volume>19</volume>
<numero>1-2</numero>
<fpage>15</fpage>
<lpage>21</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0871-34132005000100002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0871-34132005000100002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0871-34132005000100002&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[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.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[chorioamnionitis]]></kwd>
<kwd lng="en"><![CDATA[bronchopulmonary dysplasia]]></kwd>
<kwd lng="en"><![CDATA[respiratory distress syndrome]]></kwd>
</kwd-group>
</article-meta>
</front><body><![CDATA[ <P><B>Histological Chorioamnionitis and Lung Damage in Preterm Newborns </B></P>      <P>&nbsp;</P>      <P>Gustavo Rocha*, Elisa Proença†, Conceição Quintas‡, Teresa Rodrigues§, Hercília    Guimarães* </P>      <P>&nbsp;</P>      <P>*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 </P>        <P>&nbsp;</P>          <P align="justify">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.</P>     <P align="justify">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.</P>     <P align="justify">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.</P>     <P align="justify">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.         ]]></body>
<body><![CDATA[<P><b>Key-words:</b> chorioamnionitis; bronchopulmonary dysplasia; respiratory    distress syndrome. </P>      <P>&nbsp;</P>     <P>Texto completo disponível apenas em PDF.</P>     <P>Full text only available in PDF format.</P>     <P>&nbsp;</P>      <P><b>REFERENCES</b></P>      <!-- ref --><P>1 - Gomez R, Romero R, Edwin S, David C. Pathogenesis of preterm labour and    preterm premature rupture of membranes associated with intra-amniotic infection.    Infect Dis Clin North Am 1997;11:135-76. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=000019&pid=S0871-3413200500010000200001&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --><P>2 - Rangel-Frausto M, Pittet D, Costigan M, Hwang T, Davis CS, Enzel RP. The    natural history of the systemic inflammatory response syndrome (SIRS): A prospective    study. JAMA 1995;273:117-23. </P>      <P>3 - Sperr CP: Inflammation and bronchopulmonary dysplasia. Semin Neonatol 2003;8:29-38.  </P>      <P>4 - Jobe AH, Newnham JP, Willet KE, Sly P, Ervin MG, Bachurski C, Passmayer    F, Hallman M, Ikegami M: Effects of antenatal endotoxin and glucocorticoids    on the lungs of preterm lambs. Am J Obstet Gynecol 2000;182:401-8. </P>      ]]></body>
<body><![CDATA[<P>5 - Willet KE, Jobe AH, Ikegami M, Newnham JP, Brennan S, Sly PD. Antenatal    endotoxin and glucocorticoid effects on the lung morphometry in preterm lambs.    Pediatr Res 2000;48:782-8. </P>      <P>6 - Schmidt B, Cao L, Mackensen-Haen S, Kendziorra H, Klingel K, Speer CP.    Chorioamnionitis and inflammation of the fetal lung. Am J Obstet Gynecol 2001;185:173-7.  </P>      <P>7 - Murch SH, Costeloe K, Klein NJ, Rees H, McIntosh N, Keeling JW, MacDonald    TT. Mucosal tumor necrosis factor-alpha production and extensive disruption    of sulphated glycosaminoglycans begin within hours of birth in neonatal respiratory    distress syndrome. Pediatr Res 1996;40:484-9. </P>      <P>8 - Hitti J, Krohn MA, Patton DL, Tarczy-Hornoch P, Hillier SL, Cassen EM,    Eschenbach DA. Amniotic fluid tumor necrosis factor alpha and the risk of respiratory    distress syndrome among preterm infants. Am J Obstet Gynecol 1997;177:50-6.  </P>      <P>9 - Van Marter LJ, Damman O, Allred EN, Leviton A, Pagano M, Moore M, Martin    C. Chorioamnionitis, mechanical ventilation, and postnatal sepsis as modulators    of chronic lung disease in preterm infants. J Pediatr 2002;140:171-6. </P>      <P>10 - Redline RW, Wilson-Costello D, Hack M. Placental and other perinatal risk    factors for chronic lung disease in very low birth weight infants. Pediatr Res    2002;52:713-9. </P>      <P>11 - Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R. New    Ballard Score, expanded to include extremely premature infants. J Pediatr 1991;119:417-23.  </P>      <P>12 - Battaglia FC, Lubchenco LO. A practical classification of newborn infants    by weight and gestational age. J Pediatr 1967;71:159-63. </P>      <P>13 -Blanc WA. Pathology of the Placenta, Membranes, and Umbilical Cord in Bacterial,    Fungal, and Viral Infections in Man. In: Naeye RL, Kissane JM, eds. International    Academy of Pathology monograph. Perinatal Diseases by 14 authors. Baltimore:    Williams and Willkins;1981. </P>      <P>14 - Crowley PA. Antenatal corticosteroid therapy: a metaanalisys of randomized    trial, 1972 to 1994. Am J Obstet Gynecol 1995;173:322-35. </P>      ]]></body>
<body><![CDATA[<P>15 - Rudolph AJ, Smith CA. Idiopathic respiratory distress syndrome of the    newborn. J Pediatr 1960;57:905-21. </P>      <P>16 - Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respi Crit Care    Med 2001;163:1723-9. </P>      <P>17 - Watterberg KL, Scott SM, Naeyer RL. Chorioamnionitis, cortisol, and acute    lung disease in very low birth weight infants. Pediatrics 1997;99:E6. </P>      <P>18 - Sapolsky R, Rivier C, Yamamoto G, Plotsky P, Vale W. Interleukin-1 stimulates    the secretion of hypothalamic corti-cotrophin-releasing factor. Science 1987;238:522-4.  </P>      <P>19 - Bernton EW, Beach JE, Holaday JW, Smallridge RC, Fein HG. Release of multiple    hormones by a direct action of interleukin-1 on pituitary cells. Science 1987;238:519-21.  </P>      <P>20 - Gross I. Regulation of fetal lung maturation. Am J Physiol 1990;259:L337-L344.  </P>      <P>21 - Newnham JP, Moss TJ, Padbury JF, Willet KE, Ikegami M, Ervin MG, Sly P,    Jobe A. the interactive effects of endotoxin with prenatal glucocorticoids on    short-term lung function in sheep. Am J Obstet Gynecol 2001;185:190-7. </P>      <P>22 - Jobe AH. The new BPD: An arrest of lung development. Pediatr Res 1999;46:641-3.  </P>      <P>23 - Shennan AT, Dunn MS, Ohlsson A, Lennox K, Hoskins EM. Abnormal pulmonary    outcomes in premature infants: Prediction from oxygen requirement in the neonatal    period. Pediatrics 1988;82:527-32. </P>      <P>24 - Speer CP. Inflammatory mechanisms in neonatal chronic lung disease. Eur    J Pediatr 1999;158 (suppl 1):18-22. </P>      ]]></body>
<body><![CDATA[<P>25 - Yoon BH, Romero R, Jun JK. Amniotic fluid cytokines (interleukin 6, tumour    necrosis factor alpha, interleukin 1ß,and interleukin 8) and the risk for the    development of bronchopulmonary dysplasia. Am J Obstet Gynecol 1997;177:825-30.  </P>      <P>26 - Yoon BH, Romero R, Sunkim K, Park JS, Ki SH, Kim BI, Jun JK. A systemic    fetal inflammatory response and the development of bronchopulmonary dysplasia.    Am J Obstet Gynecol 1999;181:773 - 9. </P>      <P>27 - Groneck P, Schmale J, Soditt V. Bronchoalveolar inflammation following    airway infection in preterm infants with chronic lung disease. Pediatr Pulmonol    2001;31:331-8. </P>      <P>28 - Ohyama M, Itani Y, Yamanaka M, Goto A, Kato K, Ijiri R, Yanaka Y. Re-evaluation    of chorioamnionitis and funisitis with a special reference to subacute chorioamnionitis.    Hum Pathol 2002;33:183-90. </P>      <P>29 - Dammann O, Leviton A, Bartels BB, Damman CE. Lung and brain damage in    preterm newborns. Biol Neonate 2004;85:305-13. </P>      <P>30 - Matsuda T, Nakajima T, Hattori S, Hanatani K, Fukazawa Y, Kosayashi K,    Fujimoto S. Necrotizing funisitis. Clinical significance and association with    chronic lung disease in premature infants. Am J Obstet Gynecol 1997;177:1402-7.  </P>      <P>&nbsp;</P>      <P align="right"><B>Correspondência:</B></P>     <P align="right"> Dr.Gustavo Rocha</P>     <P align="right">Serviço de Neonatologia</P>     ]]></body>
<body><![CDATA[<P align="right">Departamento de Pediatria</P>     <P align="right">Hospital São João</P>     <P align="right">Alameda Prof. Hernâni Monteiro</P>     <P align="right">4200-319 Porto </P>     <P align="right">e-mail: <a href="mailto:gusrocha@oninet.pt">gusrocha@oninet.pt</a>  </P>      ]]></body><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gomez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Romero]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Edwin]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[David]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
</person-group>
<article-title xml:lang="en"><![CDATA[Pathogenesis of preterm labour and preterm premature rupture of membranes associated with intra-amniotic infection.]]></article-title>
<source><![CDATA[Infect Dis Clin North Am]]></source>
<year>1997</year>
<volume>11</volume>
<page-range>135-76</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
