Histologic Chorioamnionitis and Bronchopulmonary Dysplasia in Preterm Infants: The Epidemiologic Study on Low Gestational Ages 2 Cohort - 26/07/17
, Elsa Lorthe, RM, MSc 1, 4, François Goffinet, MD, PhD 1, 2, 5, Gilles Kayem, MD, PhD 1, 4, 6, Damien Subtil, MD, PhD 7, Patrick Truffert, MD, PhD 8, Louise Devisme, MD 9, Valérie Benhammou, PhD 1, Pierre-Henri Jarreau, MD, PhD 1, 2, 3, Pierre-Yves Ancel, MD, PhD 1, 2, 10Abstract |
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.
Le texte complet de cet article est disponible en PDF.Keywords : bronchopulmonary dysplasia, chorioamnionitis, inflammation, premature birth, preterm labor, preterm premature rupture of the membranes
Abbreviations : BPD, EPIPAGE, FGR, HCA, pPROM
Plan
| Supported by the French Institute of Public Health Research/Institute of Public Health and its partners the French Health Ministry, the National Institute of Health and Medical Research, the National Institute of Cancer, and the National Solidarity Fund for Autonomy; the National Research Agency through the French Equipex Program of Investments in the Future (ANR-11-EQPX-0038); and the PremUp Foundation. H.T. was supported by the Fondation Pour la Recherche Médicale (FDM20150633270). The authors declare no conflicts of interest. |
Vol 187
P. 98 - août 2017 Retour au numéro
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