A comparison of adverse maternal and fetal outcomes between histologic and clinical chorioamnionitis: A cross-sectional study

BACKGROUND: Chorioamnionitis may present either histologically, in the absence of clinical signs and symptoms, or clinically, when overt manifestations and laboratory markers are present. This study aimed to compare the adverse maternal and fetal outcomes between histologic and clinical chorioamnionitis in a tertiary hospital in Manila. METHODS: This is a single-center, retrospective, cross-sectional study of patients who delivered in a tertiary hospital in Manila from January 2019 to December 2023, comparing the adverse maternal and fetal outcomes between histologic chorioamnionitis and clinical chorioamnionitis. RESULTS: Maternal outcomes were generally similar between the two groups. However, among fetal outcomes, the need for mechanical ventilation was more frequently observed in neonates born to mothers with clinical chorioamnionitis. In addition to clinical chorioamnionitis, meconium-stained amniotic fluid was strongly associated with low APGAR scores, neonatal intensive care unit admission, and mechanical ventilation use. Conversely, a higher prepregnant body mass index and labor augmentation with oxytocin appeared to have potentially protective effects. CONCLUSION: These findings emphasize that clinical chorioamnionitis remains a critical determinant of neonatal respiratory morbidity and highlight the importance of heightened perinatal surveillance, as well as early recognition and timely management