Impact of clinical and/or histological chorioamnionitis on neurodevelopmental outcomes in preterm infants: A literature review - 13/05/17

Doi : 10.1016/j.jogoh.2017.02.007

E. Maisonneuve ^a,^b,^c,^⁎ , P.-Y. Ancel ^c,^d, L. Foix-L’Hélias ^b,^c,^e, S. Marret ^f,^g, G. Kayem ^b,^c,^h
^a Fetal Medicine Department, hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France
^b Pierre-et-Marie-Curie University, 75252 Paris cedex 05, France
^c Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Statistics Sorbonne Paris Cité, Inserm U1153, 53, avenue de l’Observatoire, 75014 Paris, France
^d Paris Descartes University, 75006 Paris, France
^e Neonatology Department, hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France
^f Neonatal pediatrics and intensive care unit, Neuro-pediatrics Department, centre de référence des troubles des apprentissages de l’enfant, CAMPS, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France
^g Inserm U1245, équipe Neovasc – handicap périnatal, Institut de recherche et d’innovation biomédicale, faculté de médecine et de pharmacie de Rouen, University of Normandy, 76000 Rouen, France
^h Obstetrics and Gynecology Department, hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France

^⁎Corresponding author. Fetal Medicine Department, hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France.

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Abstract

Objective

To determine the impact of clinical and/or histological chorioamnionitis on neurodevelopmental outcomes in premature infants.

Methods

A review of the literature appeared in PubMed between 1997 and 2016 was conducted to examine the association between clinical and/or histological chorioamnionitis and neurologic impairment in the neonates (intraventricular hemorrhage, periventricular leukomalacia and white matter damage) and in infants (cerebral palsy and neurodevelopmental delay).

Results

The first meta-analysis published in 2000 observed that clinical chorioamnionitis was associated with cystic periventricular leukomalacia and cerebral palsy and that histologic chorioamnionitis was associated with periventricular leukomalacia only. A second meta-analysis in 2010 found that cerebral palsy was associated with both clinical and histological chorioamnionitis. But most recent studies over the last decade based on large cohorts found no effect of chorioamnionitis on neurological outcomes, even if they had several methodological limitations.

Conclusion

According to the findings of the most recent studies, clinical or histological chorioamnionitis does not seem to be associated with neonatal white matter injuries, or with cerebral palsy. Further studies are needed to assess the impact of chorioamnionitis on long-term neurological development.

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Keywords : Clinical chorioamnionitis, Histological chorioamnionitis, Cerebral palsy, Severe intraventricular hemorrhage, Periventricular leukomalacia, Preterm