Maternal Chorioamnionitis and Postneonatal Respiratory Tract Infection in Ex-Preterm Infants

David P. Burgner, Dorota A Doherty, James Humphreys, Andrew Currie, Karen Simmer, Adrian K Charles, Tobias Strunk

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)62-67.e2
Number of pages8
JournalJournal of Pediatrics
Volume184
DOIs
Publication statusPublished - 1 May 2017

Keywords

  • histologic chorioamnionitis
  • infection-related hospitalization
  • preterm infant

Cite this

Burgner, David P. ; Doherty, Dorota A ; Humphreys, James ; Currie, Andrew ; Simmer, Karen ; Charles, Adrian K ; Strunk, Tobias. / Maternal Chorioamnionitis and Postneonatal Respiratory Tract Infection in Ex-Preterm Infants. In: Journal of Pediatrics. 2017 ; Vol. 184. pp. 62-67.e2.
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title = "Maternal Chorioamnionitis and Postneonatal Respiratory Tract Infection in Ex-Preterm Infants",
abstract = "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.",
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Maternal Chorioamnionitis and Postneonatal Respiratory Tract Infection in Ex-Preterm Infants. / Burgner, David P.; Doherty, Dorota A; Humphreys, James; Currie, Andrew; Simmer, Karen; Charles, Adrian K; Strunk, Tobias.

In: Journal of Pediatrics, Vol. 184, 01.05.2017, p. 62-67.e2.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Maternal Chorioamnionitis and Postneonatal Respiratory Tract Infection in Ex-Preterm Infants

AU - Burgner, David P.

AU - Doherty, Dorota A

AU - Humphreys, James

AU - Currie, Andrew

AU - Simmer, Karen

AU - Charles, Adrian K

AU - Strunk, Tobias

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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

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