Chorioamnionitis and the prognosis for term infants

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Abstract

Objective: To assess the effects of clinical chorioamnionitis and labor complications on short-term neonatal morbidity, including seizures. Methods: This was a retrospective cohort study of all live-born term infants who weighed more than 2500 g delivered between 1988 and 1997 at Parkland Memorial Hospital, Dallas, Texas. Infant outcomes were compared between women with and without clinical diagnoses of chorioamnionitis. Chorioamnionitis was based on maternal fever of 38C or greater with supporting clinical evidence including fetal tachycardia, uterine tenderness, and malodorous infant. Results: A total of 101,170 term infants were analyzed, 5144 (5%) of whom were born to women with chorioamnionitis. Apgar scores of 3 or less at 5 minutes, umbilical artery pH of 7.0 or less, delivery-room intubation, sepsis, pneumonia, seizures in the first 24 hours, and meconium aspiration syndrome were all increased in infants exposed to chorioamnionitis. After adjustment for confounding factors, including route of delivery and length of labor, chorioamnionitis remained significantly associated with intubation in the delivery room (odds ratio [OR] 2.0; 95% confidence interval [CI] 1.5, 2.6), pneumonia (OR 2.2; 95% CI 1.7, 2.8), and sepsis (OR 2.9; 95% CI 2.1, 4.1). Short-term neurologic morbidity, manifest as seizures, was not related to maternal infection during labor, but was significantly related to other labor complications. Conclusion: The main short-term neonatal consequence of chorioamnionitis is infection. Short-term neurologic morbidity in infants is related to labor complications and not chorioamnionitis per se.

Original languageEnglish (US)
Pages (from-to)274-278
Number of pages5
JournalObstetrics and Gynecology
Volume94
Issue number2
DOIs
StatePublished - Aug 1999

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Chorioamnionitis
Obstetric Labor Complications
Delivery Rooms
Seizures
Odds Ratio
Confidence Intervals
Morbidity
Intubation
Nervous System
Sepsis
Pneumonia
Mothers
Meconium Aspiration Syndrome
Umbilical Arteries
Apgar Score
Infection
Tachycardia
Cohort Studies
Fever
Retrospective Studies

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Chorioamnionitis and the prognosis for term infants. / Alexander, James M.; McIntire, Donald M.; Leveno, Kenneth J.

In: Obstetrics and Gynecology, Vol. 94, No. 2, 08.1999, p. 274-278.

Research output: Contribution to journalArticle

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abstract = "Objective: To assess the effects of clinical chorioamnionitis and labor complications on short-term neonatal morbidity, including seizures. Methods: This was a retrospective cohort study of all live-born term infants who weighed more than 2500 g delivered between 1988 and 1997 at Parkland Memorial Hospital, Dallas, Texas. Infant outcomes were compared between women with and without clinical diagnoses of chorioamnionitis. Chorioamnionitis was based on maternal fever of 38C or greater with supporting clinical evidence including fetal tachycardia, uterine tenderness, and malodorous infant. Results: A total of 101,170 term infants were analyzed, 5144 (5{\%}) of whom were born to women with chorioamnionitis. Apgar scores of 3 or less at 5 minutes, umbilical artery pH of 7.0 or less, delivery-room intubation, sepsis, pneumonia, seizures in the first 24 hours, and meconium aspiration syndrome were all increased in infants exposed to chorioamnionitis. After adjustment for confounding factors, including route of delivery and length of labor, chorioamnionitis remained significantly associated with intubation in the delivery room (odds ratio [OR] 2.0; 95{\%} confidence interval [CI] 1.5, 2.6), pneumonia (OR 2.2; 95{\%} CI 1.7, 2.8), and sepsis (OR 2.9; 95{\%} CI 2.1, 4.1). Short-term neurologic morbidity, manifest as seizures, was not related to maternal infection during labor, but was significantly related to other labor complications. Conclusion: The main short-term neonatal consequence of chorioamnionitis is infection. Short-term neurologic morbidity in infants is related to labor complications and not chorioamnionitis per se.",
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