PREVALENCE AND RISK-FACTORS OF CHORIOAMNIONITIS AMONG ADOLESCENTS

Objective: To identify the prevalence of chorioaminionitis and unique risk factors for this disorder among adolescents under 18 years of age . Methods: At their first prenatal visit we interviewed 352 adolescent s who received prenatal care and delivered an infant at our institutio n between April 20, 1992, and November 10, 1994, to elicit information on demographic characteristics and behavioral risk factors. Retrospec tive chart review confirmed the presence of chorioamnionitis using acc epted clinical criteria. We determined reproductive history, evidence of sexually transmitted disease, duration of labor, use of oxytocin, a n internal uterine pressure monitor or conduction anesthesia, timing a nd duration of ruptured membranes, type of delivery, and infant birth weight from review of subjects' charts. Logistic regression analysis w as used to develop adjusted odds ratios (ORs) and 95% confidence inter vals (CIs) for risk factors of chorioaminionitis. Results: Ten percent (34 of 352) of adolescents met the clinical definition for chorioamni onitis. Alcohol and tobacco use during pregnancy (OR 7.6; 95% CI 2.3, 25.8) and being married or living with a partner (OR 2.7; 95% CI 1.1, 6.5) were significantly associated with chorioamnionitis, as was condu ction anesthesia (OR 4.1; 95% CI 1.1, 15.4), a second stage labor long er than 2 hours (OR 3.5; 95% CI1.4, 8.5), and rupture of the membranes longer than 18 hours (OR 6.9; 95% CI 2.5, 18.9). Parity or preterm de livery did not differ significantly between those with or without chor ioamnionitis. Conclusion: These data suggest that in addition to risk factors observed in adults, adolescents who concurrently use tobacco a nd alcohol during pregnancy, are married or living with a male partner , and have conduction anesthesia are at increased risk for chorioamnio nitis. (Obstet Gynecol 1998; 92:254-7. (C) 1998 by The American Colleg e of Obstetricians and Gynecologists.).