Histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants

BACKGROUND: Histologic chorioamnionitis (HCA) is implicated in the onset of preterm labor and delivery. Chorioamnionitis is a known risk factor for early-onset sepsis and may modulate postnatal immunity. Preterm infants are at greatly increased risk of late-onset sepsis (LOS), particularly with coag...

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Main Authors: Strunk, T., Doherty, D., Jacques, Angela, Simmer, K., Richmond, P., Kohan, R., Charles, A., Burgner, D.
Format: Journal Article
Published: American Academy of Pediatrics 2012
Online Access:http://hdl.handle.net/20.500.11937/52534
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author Strunk, T.
Doherty, D.
Jacques, Angela
Simmer, K.
Richmond, P.
Kohan, R.
Charles, A.
Burgner, D.
author_facet Strunk, T.
Doherty, D.
Jacques, Angela
Simmer, K.
Richmond, P.
Kohan, R.
Charles, A.
Burgner, D.
author_sort Strunk, T.
building Curtin Institutional Repository
collection Online Access
description BACKGROUND: Histologic chorioamnionitis (HCA) is implicated in the onset of preterm labor and delivery. Chorioamnionitis is a known risk factor for early-onset sepsis and may modulate postnatal immunity. Preterm infants are at greatly increased risk of late-onset sepsis (LOS), particularly with coagulase-negative staphylococci (CoNS), but the impact of HCA on the risk of LOS is unknown. METHODS: Eight hundred thirty-eight preterm infants born at <30 weeks gestational age at a single tertiary center were included. Histologic examination of placenta and extraplacental membranes was performed, and clinical data were extracted from hospital databases. The influence of HCA on the incidence of early-onset sepsis and LOS was examined using logistic regression analysis and Cox proportional hazards regression. RESULTS: Mean gestational age was 26.9 +/- 1.9 weeks, and mean birth weight was 936 +/- 277 g. Two hundred and seventy-six (33%) of 838 infants developed LOS. The presence of fetal or maternal HCA, or maternal HCA and fetal HCA alone, was associated with a significantly decreased risk of LOS with any organism. Histologic chorioamnionitis correlated with a significantly decreased risk of CoNS LOS. CONCLUSIONS: HCA is associated with a significantly reduced risk of acquiring LOS, both with CoNS and other bacteria. Perinatal inflammation may enhance the functional maturation of the preterm immune system and provide protection against LOS in high-risk preterm infants.
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spelling curtin-20.500.11937-525342017-09-13T15:39:43Z Histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants Strunk, T. Doherty, D. Jacques, Angela Simmer, K. Richmond, P. Kohan, R. Charles, A. Burgner, D. BACKGROUND: Histologic chorioamnionitis (HCA) is implicated in the onset of preterm labor and delivery. Chorioamnionitis is a known risk factor for early-onset sepsis and may modulate postnatal immunity. Preterm infants are at greatly increased risk of late-onset sepsis (LOS), particularly with coagulase-negative staphylococci (CoNS), but the impact of HCA on the risk of LOS is unknown. METHODS: Eight hundred thirty-eight preterm infants born at <30 weeks gestational age at a single tertiary center were included. Histologic examination of placenta and extraplacental membranes was performed, and clinical data were extracted from hospital databases. The influence of HCA on the incidence of early-onset sepsis and LOS was examined using logistic regression analysis and Cox proportional hazards regression. RESULTS: Mean gestational age was 26.9 +/- 1.9 weeks, and mean birth weight was 936 +/- 277 g. Two hundred and seventy-six (33%) of 838 infants developed LOS. The presence of fetal or maternal HCA, or maternal HCA and fetal HCA alone, was associated with a significantly decreased risk of LOS with any organism. Histologic chorioamnionitis correlated with a significantly decreased risk of CoNS LOS. CONCLUSIONS: HCA is associated with a significantly reduced risk of acquiring LOS, both with CoNS and other bacteria. Perinatal inflammation may enhance the functional maturation of the preterm immune system and provide protection against LOS in high-risk preterm infants. 2012 Journal Article http://hdl.handle.net/20.500.11937/52534 10.1542/peds.2010-3493 American Academy of Pediatrics restricted
spellingShingle Strunk, T.
Doherty, D.
Jacques, Angela
Simmer, K.
Richmond, P.
Kohan, R.
Charles, A.
Burgner, D.
Histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants
title Histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants
title_full Histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants
title_fullStr Histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants
title_full_unstemmed Histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants
title_short Histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants
title_sort histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants
url http://hdl.handle.net/20.500.11937/52534