Impact of chorioamnionitis on short- and long-term outcomes in very low birth weight preterm infants: the Neonatal Research Network Japan

Abstract

Objective: To evaluate the short- and long-term outcomes among very low birth weight (VLBW) preterm infants after histologic chorioamnionitis (HCA).

Methods: We performed a retrospective analysis of 5849 single infants (birth weight <1500 g) born at a gestational age between 22 + 0 and 33 + 6 weeks. Clinical data were obtained from the Neonatal Research Network Japan between 2003 and 2007. Multivariable logistic regression analyses were performed to assess the effect of HCA on short- and long-term outcome.

Results: According to logistic regression analysis, HCA was associated with lower incidence of respiratory distress syndrome (odds ratio [OR] = 0.54; p < 0.001), increased chronic lung disease (OR = 1.68; p < 0.001) and sepsis (OR = 1.71; p < 0.001) and as a short-term outcomes. There was no significant association with intraventricular hemorrhage (OR = 1.11; p = 0.33), periventricular leukomalacia (OR = 1.07; p = .070) and death before discharge (OR = 0.97; p = 0.084). HCA was associated with increased home oxygen therapy (OR = 3.09; p < 0.001), but not with cerebral palsy (CP; OR = 0.91; p = 0.63), develop quotient < 70 (OR = 1.27; p = 0.17), visual impairment (OR = 1.08; p = 0.77), severe hearing impairment (OR = 1.28; p = 0.62) and death (OR = 0.98; p = 0.91) before three years of age.

Conclusions: In this retrospective population-based study in Japan, HCA was not a risk factor for death, neurodevelopmental impairment and CP in VLBW three-year-old preterm infants.

• Cerebral palsy
• histologic chorioamnionitis
• mortality
• neurodevelopmental impairment
• premature infants

Acknowledgements

We thank the institutions and representative physicians enrolled in the Neonatal Research Network Database of Japan, which include: Sapporo City General Hospital: S. Hattori; Kushiro Red Cross Hospital: A. Noro; Aomori Prefectural Central Hospital: T. Amizuka; Iwate Medical University: S. Chida; Sendai Red Cross Hospital: R. Takahashi; Akita Red Cross Hospital: H. Arai; Fukushima Medical University: T. Imamura; National Fukushima Hospital: N. Ujiie; University of Tsukuba: Y. Miyazono; Tsuchiura Kyodo General Hospital: J. Shimizu; Dokkyo Medical University: H. Suzumura; Jichi Medical University: Y. Kono; Saitama Children’s Medical Center: M. Shimizu; Saitama Medical University Saitama Medical Center: T. Kunikata; Gunma Children’s Medical Center: T. Fujiu; Kameda Medical Center: H. Sato; Tokyo Women’s Medical University Yachiyo Medical Center: T. Kondo; Tokyo Metropolitan Bokuto Hospital: T. Watanabe; Showa University: M. Aizawa; Tokyo Women’s Medical University: A. Uchiyama; Nihon University Itabashi Hospital: M. Makimoto; Teikyo University: J. Hoshi; Toho University: H. Yoda; Japan Red Cross Medical Center: Y. Kawakami; Aiiku Hospital: N. Ishii; National Center for Child Health and Development: Y. Ito; Kanagawa Children’s Medical Center: H. Itani; Yokohama City University Medical Center: K. Seki; Tokai University: M. Nomura; Kitazato University: M. Nowatari; Yamanashi Prefectural Central Hospital: A. Nemoto; Nagaoka Red Cross Hospital: O. Nagata; Niigata City Hospital: Y. Nagayama; Nagano Children’s Hospital: T. Nakamura; Shinshu University: M. Okada; Iida City Hospital: S. Nakata; National Nagano Hospital: E. Shimazaki; Saku General Hospital: T. Yoda; Toyama Prefectural Central Hospital: T. Hutatani; Ishikawa Prefectural Central Hospital: Y. Ueno; Fukui Prefectural Hospital: K. Iwai; Shizuoka Children’s Hospital: Y. Nakazawa; Seirei Hamamatsu General Hospital: S. Oki; Nagoya Red Cross First Hospital: C. Suzuki; National Mie Hospital: M. Bonno; Gifu Prefectural Central Hospital: Y. Kawano; Otsu Red Cross Hospital: K. Nakamura; Kyoto Red Cross First Hospital: N. Mitsufuji; Osaka Medical Center and Research Institute for Maternal and Child Health: J. Shiraishi; Osaka City General Hospital: H. Ichiba; Takatsuki Hospital: H. Minami; Yodogawa Christian Hospital: H. Wada; Kansai Medical University: A. Ohashi; Aizenbashi Hospital: K. Sumi; Nara Medical University: Y. Takahashi; Wakayama Prefectural Medical University: T. Okutani; Hyogo Prefectural Kobe Children’s Hospital: S. Yoshimoto; Tottori University: I. Nagata; Shimane Prefectural Central Hospital: E. Kato; Kurashiki Central Hospital: S. Watabe S; National Okayama Hospital: M. Kageyama; Hiroshima Prefectural Hospital: R. Fukuhara; Hiroshima City Hospital: M. Hayashitani; Yamaguchi Prefectural Medical Center: K. Hasegawa; National Kagawa Children’s Hospital: A. Ohta; Kagawa University: T. Kuboi; Ehime Prefectural Central Hospital: S. Akiyoshi; Kochi Health Sciences Center: K. Kikkawa; Tokushima University: T. Saijo; St. Mary’s Hospital: S. Shimokawa; Kitakyushu City Municipal Medical Center: N. Matsumoto; Kurume University: H. Kanda; Fukuoka University: E. Oota; National Kyushu Medical Center: G. Kanda; Kyushu University: M. Ochiai; National Nagasaki Medical Center: M. Aoki; Kumamoto City Hospital: Y. Kondo; Kumamoto University: M. Iwai; Oita Prefectural Hospital: K. Iida; Miyazaki University: T. Ikenoue; Kagoshima City Hospital: S. Ibara; and Okinawa Chubu Hospital: M. Kohama.

Declaration of interest

This study was partly supported by a grant from the Ministry of Health, Labor and Welfare, Japan (H16-kodomo-ippan-032, H19-kodomo-ippan-005, H22-jisedai-ippan-006).