Histologic chorioamnionitis and acute neurologic impairment in premature infants

Abstract

Objective. To determine if histologic chorioamnionitis is associated with acute neurologic impairment as evaluated by auditory brainstem response in premature infants.

Methods. A prospective study was performed to compare auditory neural function at birth between premature infants with maternal histologic chorioamnionitis and infants without maternal histologic chorioamnionitis. Our inclusion criteria was 28–33 weeks gestational age (GA) infants who had maternal placental histopathology performed. Infants with toxoplasmosis, other infections, rubella, cytomegalovirus and herpes simplex (TORCH) infections, chromosomal disorders, cranio-facial anomalies and/or unstable condition were excluded. Bilateral monaural auditory brainstem evoked responses were performed using 80 dB nHL click stimuli at a repetition rate of 29.9/s within 48 h after birth.

Results. Of 101 infants who met study criteria, 29 infants were born with history of maternal histologic chorioamnionitis. There were no significant differences between infants with histologic chorioamnionitis and infants without histologic chorioamnionitis in perinatal factors except for GA, pregnancy induced hypertension, and exposure to antenatal magnesium sulphate. After controlling for confounders, histologic chorioamnionitis was not associated with prolonged absolute wave latencies I, III, and V and/or decreased frequency of mature audtory waveform compared to infants without histologic chorioamnionitis.

Conclusion. Histologic chorioamnionitis is not associated with neurologic impairment at birth in premature infants.

Keywords:

• Neurologic impairment
• histologic chorioamnionitis
• premature infants
• white matter injury
• periventricular leukomalacia

Acknowledgements

The authors are grateful to Erica Burnell, research coordinator, for data collection, to the audiology group (Mark Orlando, Ann Eddins, Matthew MacDonald, Christy Monczynski, Diane Pucci, and Amber Lim) at the University of Rochester for performing auditory brainstem evoked responses. They are also grateful to Phillip Katzman, MD, a paediatric pathologist at the University of Rochester, for review of placental pathology. The research was partly supported by NIH K-23 DC 006229-04.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.