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- W2997201412 abstract "We investigated the association between histopathologic chorioamnionitis and neurodevelopmental impairment at 10 years of age among children born extremely preterm (EP, i.e., < 28 weeks gestation). The multicenter Extremely Low Gestational Age Newborn (ELGAN) Study enrolled EP newborns from 2002-2004 at 14 U.S. hospitals. Chorioamnionitis was defined by gold-standard histopathologic stage and grade of chorionic plate and umbilical cord inflammation. The children were evaluated for cerebral palsy, autism spectrum disorder, epilepsy, and cognitive impairment (IQ more than 2 standard deviations below the mean) at 10 years of age by blinded evaluators using validated measures. We evaluated associations using multivariable logistic regression with generalized estimating equations. Among 805 mothers, 43% (347/805) had histopathologic chorioamnionitis by moderate/advanced maternal stage, 36% (286/805) by severe maternal grade, 18% (135/752) by moderate/advanced fetal stage, and 1% (9/752) by severe fetal grade. The frequency at 10 years was 11% (88/767) for cerebral palsy, 6% (51/788) for cognitive impairment, 7% (52/763) for epilepsy, and 7% (56/773) for autism spectrum disorder (Figure). Chorioamnionitis was associated with higher likelihood of cerebral palsy, cognitive impairment, and epilepsy, but not autism spectrum disorder (Table). The adjusted odds for cerebral palsy varied minimally with severity/location of chorioamnionitis (advanced maternal stage: 2.4; 95%CI: 1.5-3.8; severe maternal grade: 2.01; 95%CI: 1.2-3.3; moderate fetal stage: 2.0; 95%CI: 1.9-2.2; and mild/moderate fetal grade: 1.5; 95%CI: 1.2-1.7); as did cognitive impairment (advanced maternal stage: 1.1; 95%CI: 1.1-1.2 and early fetal stage: 2.2; 95%CI: 1.0-5.2); and epilepsy (advanced maternal stage: 1.4; 95%CI: 1.3-1.6 and severe fetal grade: 3.8; 95%CI: 1.2-11.4). These findings held after adjustment for gestational age at delivery. Chorioamnionitis is associated with an increased risk of neurodevelopmental impairment at 10 years of life among infants born extremely preterm.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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- W2997201412 date "2020-01-01" @default.
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- W2997201412 title "1163: Histopathologic chorioamnionitis and risk of neurodevelopmental impairment at age 10 years among extremely preterm infants" @default.
- W2997201412 doi "https://doi.org/10.1016/j.ajog.2019.11.1175" @default.
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