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Chorioamnioitis and Respiratory Outcome in Very Low Birthweight Infants who received Antenatal Corticosteroids

Presented at the Neonatal Society 2013 Summer Meeting (programme).

Howell AJ, Harding D

St Michaels Hospital Bristol, UK
University Hospital of Bristol NHS Trust, UK

Background: The respiratory outcome of those babies with histological chorioamnionitis treated with antenatal corticosteroids have not been examined in a UK population of infants born weighing <1500g. Our aim was to determine if there was any association between chorioamnionitis and adverse respiratory outcomes in our population of VLBW infants who received antenatal corticosteroids.

Methods: 294 VLBW babies born in our hospital between Jan 2001 and Dec 2010 who had received antenatal corticosteroids and had placental histology performed were identified. Infant characteristics and outcomes were as described by the Vermont-Oxford data definitions. Statistical analysis was performed in SPSS, using chi square, student t-test and logistic regression where appropriate.

Results: 97 babies out of 294 babies (33%) had histological chorioamnionitis (58 of whom had funisitis). The presence of chorioamniionitis was associated with increased need for ventilation (85% vs 69% infants p = 0.006), diagnosis of respiratory distress syndrome (87% vs 71% p = 0.004) and need for oxygen at time of discharge (51% vs 33% p = 0.007). However the group of babies with chorioamnionitis were 2 weeks more immature than those without chorioamnionitis (mean gestational age at birth 27 wks vs 29wks, mean dif. -2.2, p<0.001) . After logistic regression to account for potential effects of gestational age the presence of chorioamnionitis was not associated with any respiratory sequel.

Conclusion: In our population of infants born <1500g and treated with antenatal corticosteroids the presence of histological chorioamnionitis is not associated with respiratory status after adjusting for earlier birth. The most significant predictor of respiratory progress is gestational age at delivery.

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