Outcome of very low birth weight infants with histopathologic chorioamnionitis

Objective: To determine neonatal outcome at 7 months of corrected age in ve ry low birth weight (VLBW) infants with placental chorioamnionitis. Methods: We conducted a cohort study of 287 VLBW infants delivered as a res ult of preterm premature rupture of membranes (PROM) or preterm labor. Cont rol subjects (n = 123) had placentas with absent umbilical cord inflammatio n and absent or low-grade membrane inflammation. Case subjects (n = 164) ha d moderate membrane inflammation or any umbilical cord inflammation. Neonat al and 7-month outcomes were compared. A power analysis showed that 98 tota l subjects were needed to reject the two-sided null hypothesis with a diffe rence in mean Bayley index scores of at least 8. Results: Infants in the study group had significantly more preterm FROM, an tenatal antibiotics, lower birth weight, lower gestational age, longer dura tion of ruptured membranes, and clinical chorioamnionitis. Intraventricular hemorrhage occurred more commonly in infants with placentas demonstrating chorioamnionitis (relative risk = 1.6, 95% confidence interval 1.1, 2.4, P = .013). One hundred sixty-seven (69%) of the 243 surviving infants had 7-m onth followup. There was no difference between cases and controls in mean B ayley mental developmental index (93 compared with 90, P = .25), psychomoto r developmental index (89 compared with 90, P = .68), or in the number of i nfants that were developmentally delayed. Conclusion: Despite a higher frequency of intraventricular hemorrhage, no d ifference in developmental scores was detected at 7 months of corrected age in VLBW infants with histologic chorioamnionitis. (C) 2000 by The American College of Obstetricians and Gynecologists.