The Effects of Histologic Chorioamnionitis and Funisitis on Outcome of Very Low Birth Weight Infants / 대한주산의학회잡지

ABSTRACT

PURPOSE: The association of chorioamnionitis and preterm birth, chronic lung disease (CLD) and periventricular leukomalacia (PVL) has been reported, however, controversy is still present. The aim of this study was to investigate how the histologic chorioamnionitis (HC) and/or funisitis (F) affected the clinical outcomes of very low birth weight infants (VLBWI, <1,500 g). METHODS: The medical records of VLBWI who were admitted at NICU, Chonnam University Hospital from 2004 to 2008 with placental biopsy results were reviewed retrospectively. Maternal (n=324) and neonatal (n=363) characteristics and their clinical outcomes were investigated according to placental pathology. RESULTS: HC (+) mothers (n=88) had higher premature rupture of membranes and preterm labor, and lower rates of preeclampsia/eclampsia (p<0.05 at each) than HC (-) mothers (n=236). HC (+) infants (n=103) had lower birth weight and Apgar score, higher rate of Cesarean section and lower intrauterine growth restriction (p<0.05 at each) rates than HC (-) infants (n=260). HC (+) infants had higher rates of respiratory distress syndrome and mortality, and lower rate of necrotizing enterocolitis (p<0.05 at each), however, when adjusted for verified multivariables in the multiple regression analysis, HC didn't affect the clinical outcomes. CONCLUSION: It was known that intrauterine infection or fetal inflammatory response syndrome (FIRS) was associated with neonatal outcomes. However, our results suggest that HC with or without funisitis is not an isolated risk factor to affect the clinical outcomes in VLBWI.