Chorioamnionitis and neurodevelopmental outcome in very preterm infants from 2007 to 2017-a population-based study

Acta Paediatr. 2021 Apr;110(4):1201-1208. doi: 10.1111/apa.15715. Epub 2020 Dec 20.

Abstract

Aim: The study compares neurodevelopmental outcome at 24 months corrected age of very preterm infants exposed to chorioamnionitis and controls. Peripartal parameters which may influence outcome are also investigated.

Methods: In this observational population-based study, very preterm infants born between 2007 and 2017 were eligible (n = 466) and included if a histological placental examination and a complete neurodevelopmental assessment (Bayley Scale of Infant Development II or III) (n = 168) were performed. Secondary analyses were calculated to identify peripartal factors that significantly influence mental and psychomotor outcome.

Results: Included infants showed a mean MDI of 91.2 (SD = 20.7) and a mean PDI of 99.4 (SD = 14.8). Infants with (n = 71) and without (n = 97) chorioamnionitis did not statistically differ either with mean MDI (91.8 vs. 90.3 points; p = 0.29) or mean PDI (98.3 vs. 100.9 points; p = 0.81), even after controlling for gestational age, mean APGAR scores and administration of antenatal steroids. Bronchopulmonary dysplasia was identified as the most influential factor for both MDI (p = .024) and PDI (p = .004).

Conclusion: We could not find an effect of chorioamnionitis on neurodevelopmental outcome of very preterm infants over an eleven-year period. Analysis shows that postnatal factors have higher impacts than does chorioamnionitis.

Keywords: bayley scale of infant development; chorioamnionitis; neurodevelopmental outcome; very preterm infants.

MeSH terms

  • Child
  • Child Development
  • Chorioamnionitis* / epidemiology
  • Female
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases* / epidemiology
  • Infant, Premature, Diseases* / etiology
  • Infant, Very Low Birth Weight
  • Pregnancy