Clinical Chorioamnionitis and Neurodevelopment at 5 Years of Age in Children Born Preterm: The EPIPAGE-2 Cohort Study - 26/03/24
, Gilles Kayem, MD, PhD 1, 3, Emeline Maisonneuve, MD 4, Laurence Foix-L’Hélias, MD, PhD 1, 5, Valérie Benhammou, PhD 1, Monique Kaminski, MSc 1, Laetitia Marchand-Martin, MSc 1, Gildas Kana, MSc 1, Damien Subtil, MD, PhD 6, Elsa Lorthe, RM, PhD 1, 7, Pierre-Yves Ancel, MD, PhD 1, 8, Mathilde Letouzey, MD, PhD 1, 9on behalf of the
EPIPAGE-2 Infectious diseases working group
Abstract |
Objective |
To assess the association between clinical chorioamnionitis and neurodevelopmental disorders at 5 years of age in children born preterm.
Study design |
EPIPAGE 2 is a national, population-based cohort study of children born before 35 weeks of gestation in France in 2011. We included infants born alive between 240/7 and 346/7 weeks after preterm labor or preterm premature rupture of membranes. Clinical chorioamnionitis was defined as maternal fever before labor (>37.8°C) with ≥2 of the following criteria: maternal tachycardia, hyperleukocytosis, uterine contractions, purulent amniotic fluid, or fetal tachycardia. The primary outcome was a composite, including cerebral palsy, coordination disorders, cognitive disorders, sensory disorders, or behavioral disorders. We also analyzed each of these disorders separately as secondary outcomes. We performed a multivariable analysis using logistic regression models. We accounted for the nonindependence of twins and missing data by generalized estimating equation models and multiple imputations, respectively.
Results |
Among 2927 children alive at 5 years of age, 124 (3%) were born in a context of clinical chorioamnionitis. Overall, 8.2% and 9.6% of children exposed and unexposed, respectively, to clinical chorioamnionitis had moderate-to-severe neurodevelopmental disorders. After multiple imputations and multivariable analysis, clinical chorioamnionitis was not associated with the occurrence of moderate-to-severe neurodevelopmental disorders (aOR, 0.9; 95% CI, 0.5-1.8).
Conclusions |
We did not find any association between clinical chorioamnionitis and neurodevelopmental disorders at 5 years of age in children born at <35 weeks of gestation after preterm labor or preterm premature rupture of membrane.
Le texte complet de cet article est disponible en PDF.Keywords : clinical chorioamnionitis, neurodevelopmental disorders, preterm birth
Abbreviation : FGR
Plan
| EPIPAGE 2 Study-group: Alsace: D. Astruc, P. Kuhn, B. Langer, J. Matis, C. Ramousset; Aquitaine: X. Hernandorena, P. Chabanier, L. Joly-Pedespan, M. Rebola, M.J. Costedoat, A. Leguen, C. Martin; Auvergne: B. Lecomte, D. Lemery, F. Vendittelli, E. Rochette; Basse-Normandie: G. Beucher, M. Dreyfus, .B Guillois, V. Datin-Dorrière, Y. Toure, D. Rots; Bourgogne: A. Burguet, S. Couvreur, J.B. Gouyon, P. Sagot, N. Colas, A. Franzin; Bretagne: J. Sizun, A. Beuchée, P. Pladys, F. Rouget, R.P. Dupuy, D. Soupre, F. Charlot, S. Roudaut; Centre: A. Favreau, E. Saliba, L. Reboul, E. Aoustin; Champagne-Ardenne: N. Bednarek, P. Morville, V. Verrière; Franche-Comté: G. Thiriez, C. Balamou, C. Ratajczak; Haute-Normandie: L. Marpeau, S. Marret, C. Barbier, N. Mestre; Ile-de-France: G. Kayem, X. Durrmeyer, M. Granier, M. Ayoubi, O. Baud, B. Carbonne, L. Foix L’Hélias, F. Goffinet, P.H. Jarreau, D. Mitanchez, .P Boileau, C. Duffaut, E. Lorthe, L. Cornu, R. Moras, D. Salomon, S. Medjahed, K. Ahmed; Languedoc-Roussillon: P. Boulot, G. Cambonie, H. Daudé, A. Badessi, N. Tsaoussis, M. Poujol; Limousin: A. Bédu, F. Mons, C. Bahans; Lorraine: M.H. Binet, J. Fresson, J.M. Hascoët, A. Milton, O. Morel, R. Vieux, L. Hilpert; Midi-Pyrénées: C. Alberge, C. Arnaud, C. Vayssière, M. Baron; Nord-Pas-de-Calais: M.L. Charkaluk, V. Pierrat, D. Subtil, P. Truffert, S. Akowanou, D. Roche, M. Thibaut; PACA et Corse: C. D'Ercole, C. Gire, U. Simeoni, A. Bongain, M. Deschamps, M. Zahed; Pays de Loire: B. Branger, J.C. Rozé, N. Winer, V. Rouger, C. Dupont, H. Martin; Picardie: J. Gondry, G. Krim, B. Baby, I. Popov; Rhône-Alpes: M. Debeir, O. Claris, J.C. Picaud, S. Rubio-Gurung, C. Cans, A. Ego, T. Debillon, H. Patural, A. Rannaud; Guadeloupe: E. Janky, A. Poulichet, J.M. Rosenthal, E. Coliné, C. Cabrera; Guyane: A. Favre, N. Joly, A. Stouvenel; Martinique: S. Châlons, J. Pignol, P.L. Laurence, V. Lochelongue; La Réunion: P.Y. Robillard, S. Samperiz, D. Ramful. |
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| Inserm UMR 1153: P.Y. Ancel, H. Asadullah, V. Benhammou, B. Blondel, A. Brinis, M.L. Charkaluk, A. Coquelin, V. Delormel, M. Durox, M. Fériaud, L. Foix-L’Hélias, F. Goffinet, M. Kaminski, G. Kayem, K. Khemache, B. Khoshnood, C. Lebeaux, E. Lorthe, L. Marchand-Martin, A. Morgan, L. Onestas, V. Pierrat, J. Rousseau, M.J. Saurel-Cubizolles, D. Tran, D. Sylla, L. Vasante-Annamale, J. Zeitlin. |
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| EPIPAGE-2 Working group on infections: Pascal Boileau, MD, PhD (Department of Neonatal Pediatrics, Poissy Saint Germain Hospital, France, Versailles Saint Quentin en Yvelines University, France), Marine Butin, MD, PhD (Department of neonatal pediatrics, Lyon, France), Laurence Foix-L’Hélias, MD, PhD (Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004 Paris, France; Department of Neonatal Pediatrics, Trousseau Hospital, AP-HP, Paris, France), Christèle Gras-Le Guen, MD PhD (Department of Pediatrics, Pediatric Emergency, Clinical investigation Center 1413 INSERM1043, CHU Nantes, Nantes, France), Gilles Kayem, MD, PhD (Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004 Paris, France; Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France), Pierre Kuhn, MD, PhD (Department of neonatal medicine, CHU Strasbourg, Strasbourg, France), Mathilde Letouzey, MD, PhD (Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004 Paris, France, Department of Neonatal Pediatrics, Poissy Saint Germain Hospital, France), Elsa Lorthe, RM, PhD (Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004 Paris, France; Unit of Population Epidemiology, Department of Primary Care Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland), Emeline Maisonneuve, MD, MSc (Institute of Primary Health Care [BIHAM]), University of Bern, Switzerland; Ayoub Mitha, MD, PhD (Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004 Paris, France; Department of neonatal medicine, Jeanne de Flandres Hospital, CHRU Lille, Lille, France), Héloïse Torchin, MD, PhD (Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004 Paris, France; Neonatal Medicine and Resuscitation Service in Port-Royal, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France), Caroline Charlier, MD, PhD (Division of Infectious Diseases and Tropical Medicine, Hôpital Université Necker-Enfants Malades, Université de Paris, APHP, Paris; Biology of Infection Unit, Institut Pasteur, French National Reference Center and WHO Collaborating Center for Listeria, Inserm U1117, Paris). |
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Article 113921- avril 2024 Retour au numéro
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