TY - JOUR
T1 - Maternal Chorioamnionitis and Postneonatal Respiratory Tract Infection in Ex-Preterm Infants
AU - Burgner, David P.
AU - Doherty, Dorota
AU - Humphreys, James
AU - Currie, Andrew
AU - Simmer, Karen
AU - Charles, Adrian
AU - Strunk, Tobias
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Objective To assess whether exposure to histologically confirmed chorioamnionitis (ie, histologic chorioamnionitis [HCA]) is associated with altered risk of infection-related hospitalization (IRH) during the first 24 months of life in very preterm infants. Study design This single-center retrospective cohort study analyzed data on 1218 infants born at <30 weeks gestational age (GA). Semiquantitative placental histology, obstetric, and neonatal data were extracted from hospital databases and linked with discharge diagnoses on rehospitalization until age 24 months from statewide statutory data. The associations between HCA and overall and clinical categories of IRH were analyzed by Cox proportional hazards regression with left-truncated failure times. Results Mean GA was 27 weeks, and HCA was present in 577 placentas (47.4%). Among the 1088 infants surviving until the birth-related discharge, 684 (62.9%) of had at least 1 IRH by age 24 months, of whom 287 included a diagnosis of acute lower respiratory tract infection (ALRTI). Following adjustment for sex, birth weight z-score, GA, early-onset sepsis, late-onset sepsis, previous antibiotic use, age at birth-related discharge, and chronic lung disease, HCA was associated with a 32% increased risk of hospitalization with ALRTI (HR, 1.32; 95% CI, 1.02-1.70; P=.033). There was no association with infection overall or with other infection categories. Conclusions HCA is associated with a significantly increased risk of hospitalization with ALRTI that is independent of known risk factors, including chronic lung disease.
AB - Objective To assess whether exposure to histologically confirmed chorioamnionitis (ie, histologic chorioamnionitis [HCA]) is associated with altered risk of infection-related hospitalization (IRH) during the first 24 months of life in very preterm infants. Study design This single-center retrospective cohort study analyzed data on 1218 infants born at <30 weeks gestational age (GA). Semiquantitative placental histology, obstetric, and neonatal data were extracted from hospital databases and linked with discharge diagnoses on rehospitalization until age 24 months from statewide statutory data. The associations between HCA and overall and clinical categories of IRH were analyzed by Cox proportional hazards regression with left-truncated failure times. Results Mean GA was 27 weeks, and HCA was present in 577 placentas (47.4%). Among the 1088 infants surviving until the birth-related discharge, 684 (62.9%) of had at least 1 IRH by age 24 months, of whom 287 included a diagnosis of acute lower respiratory tract infection (ALRTI). Following adjustment for sex, birth weight z-score, GA, early-onset sepsis, late-onset sepsis, previous antibiotic use, age at birth-related discharge, and chronic lung disease, HCA was associated with a 32% increased risk of hospitalization with ALRTI (HR, 1.32; 95% CI, 1.02-1.70; P=.033). There was no association with infection overall or with other infection categories. Conclusions HCA is associated with a significantly increased risk of hospitalization with ALRTI that is independent of known risk factors, including chronic lung disease.
KW - histologic chorioamnionitis
KW - infection-related hospitalization
KW - preterm infant
UR - http://www.scopus.com/inward/record.url?scp=85013188351&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2017.01.037
DO - 10.1016/j.jpeds.2017.01.037
M3 - Article
C2 - 28233549
AN - SCOPUS:85013188351
VL - 184
SP - 62-67.e2
JO - The Journal of Pediatrics
JF - The Journal of Pediatrics
SN - 0022-3476
ER -