Chorioamnionitis, mechanical ventilation, and postnatal sepsis as modulators of chronic lung disease in preterm infants

J Pediatr. 2002 Feb;140(2):171-6. doi: 10.1067/mpd.2002.121381.


Objective: This case-control study of chronic lung disease (CLD) evaluated the hypothesis that chorioamnionitis promotes CLD and interacts with other risk factors for CLD, including mechanical ventilation and postnatal infection.

Study design: We identified a population of 193 infants who met our case criteria for CLD whose birth weights were <or=1500 g. These infants were matched 1:1 with control infants for gestational age and hospital of birth.

Results: Univariable analyses revealed decreased CLD risk associated with histologic chorioamnionitis and increased risk associated with mechanical ventilation >7 days and culture-documented sepsis. In multivariable analyses, infants were at greatest risk for CLD when they had exposure to both chorioamnionitis and either mechanical ventilation >7 days (odds ratio, 3.2; 95% confidence interval, 0.9-11) or postnatal infection (odds ratio, 2.9; 95% confidence interval, 1.1-7.4).

Conclusions: We conclude that prolonged mechanical ventilation or postnatal infection increases the risk of CLD among surviving preterm infants and that these 2 factors interact with antenatal infection to further increase the risk of CLD.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Case-Control Studies
  • Chorioamnionitis / complications*
  • Chronic Disease
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / etiology*
  • Lung Diseases / etiology*
  • Male
  • Multivariate Analysis
  • Placenta / microbiology
  • Pregnancy
  • Respiration, Artificial
  • Sepsis / complications
  • Ureaplasma / isolation & purification