The association of chorioamnionitis with intraventricular hemorrhage and long-term outcome in very preterm neonates

Objective To evaluate the impact of chorioamnionitis on the incidence of intraventricular hemorrhage in preterm neonates and to assess its impact on neurodevelopmental outcomes at 24 months of age. Methods We retrospectively reviewed the medical records of all neonates <32 weeks’ gestational age born to mothers with and without histological chorioamnionitis. At 24 months of age, we evaluated long-term neurodevelopmental outcomes with the Gross Motor Function Classification System (GMFCS) and the Modified Checklist for Autism in Toddlers (M-CHAT). Results Among 91 neonates with a mean gestational age of 29.1(±2.2) weeks, 54% (49 newborns) were exposed to chorioamnionitis during pregnancy. Neonates born to mothers with chorioamnionitis were of significantly lower gestational age (28.0 ± 2.3 vs. 30.2 ± 1.3 weeks, p < 0.001) and birth weight (1,172 ± 400 g vs. 1,376 ± 409 g, p = 0.018) compared to neonates born to mothers without chorioamnionitis, respectively. Neonates of mothers with chorioamnionitis had an increased risk of intraventricular hemorrhage (OR 6.34, 95% CI 1.91–21.01, p = 0.003), retinopathy of prematurity (OR 2.48, 95% CI 1.13–5.46, p = 0.041), and bronchopulmonary dysplasia (OR 6.12, 95% CI 2.08–18.04, p = 0.001). After adjusting for gestational age and intraventricular hemorrhage, chorioamnionitis had an increased risk of abnormal M-CHAT (OR 4.52, 95% CI 1.12–18.20, p = 0.034) at 24 months of age. Conclusion Very preterm neonates born to mothers with chorioamnionitis are at increased risk of severe intraventricular hemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia, and an increased risk of abnormal M-CHAT at 24 months of age.