Impact of clinical and/or histological chorioamnionitis on neurodevelopmental outcomes in preterm infants: A literature review

J Gynecol Obstet Hum Reprod. 2017 Apr;46(4):307-316. doi: 10.1016/j.jogoh.2017.02.007. Epub 2017 Feb 11.

Abstract

Objective: To determine the impact of clinical and/or histological chorioamnionitis on neurodevelopmental outcomes in premature infants.

Methods: A review of the literature appeared in PubMed between 1997 and 2016 was conducted to examine the association between clinical and/or histological chorioamnionitis and neurologic impairment in the neonates (intraventricular hemorrhage, periventricular leukomalacia and white matter damage) and in infants (cerebral palsy and neurodevelopmental delay).

Results: The first meta-analysis published in 2000 observed that clinical chorioamnionitis was associated with cystic periventricular leukomalacia and cerebral palsy and that histologic chorioamnionitis was associated with periventricular leukomalacia only. A second meta-analysis in 2010 found that cerebral palsy was associated with both clinical and histological chorioamnionitis. But most recent studies over the last decade based on large cohorts found no effect of chorioamnionitis on neurological outcomes, even if they had several methodological limitations.

Conclusion: According to the findings of the most recent studies, clinical or histological chorioamnionitis does not seem to be associated with neonatal white matter injuries, or with cerebral palsy. Further studies are needed to assess the impact of chorioamnionitis on long-term neurological development.

Keywords: Cerebral palsy; Clinical chorioamnionitis; Histological chorioamnionitis; Periventricular leukomalacia; Preterm; Severe intraventricular hemorrhage.

Publication types

  • Review

MeSH terms

  • Brain / growth & development*
  • Brain / physiology
  • Chorioamnionitis / diagnosis
  • Chorioamnionitis / epidemiology*
  • Chorioamnionitis / pathology
  • Cognition / physiology*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature / growth & development*
  • Infant, Premature / psychology
  • Infant, Premature, Diseases / diagnosis
  • Infant, Premature, Diseases / epidemiology
  • Neurodevelopmental Disorders / diagnosis
  • Neurodevelopmental Disorders / epidemiology*
  • Neurodevelopmental Disorders / etiology
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Prenatal Exposure Delayed Effects / diagnosis
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Prenatal Exposure Delayed Effects / psychology*
  • Prognosis