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.
Il testo completo di questo articolo è disponibile in PDF.Keywords : bronchopulmonary dysplasia, chorioamnionitis, inflammation, premature birth, preterm labor, preterm premature rupture of the membranes
Abbreviations : BPD, EPIPAGE, FGR, HCA, pPROM
Mappa
| 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 - agosto 2017 Ritorno al numero
Articolo precedente
- Bronchopulmonary Dysplasia and Perinatal Characteristics Predict 1-Year Respiratory Outcomes in Newborns Born at Extremely Low Gestational Age: A Prospective Cohort Study
- Roberta L. Keller, Rui Feng, Sara B. DeMauro, Thomas Ferkol, William Hardie, Elizabeth E. Rogers, Timothy P. Stevens, Judith A. Voynow, Scarlett L. Bellamy, Pamela A. Shaw, Paul E. Moore
- 50 Years Ago in The Journal of Pediatrics : The Denver Developmental Screening Test
- Jennifer Accardo, Pasquale Accardo
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?