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Association of chorioamnionitis and its duration with neonatal morbidity and mortality

Journal of Perinatology volume 39, pages 673–682 (2019)Cite this article

Subjects

A Correction to this article was published on 07 March 2019

This article has been updated

Abstract

Objective

To investigate the association of chorioamnionitis, and secondarily its duration, on neonatal adverse outcomes for infants born <34 weeks vs. ≥34 weeks.

Study design

A secondary analysis from the observational U.S. Consortium on Safe Labor Study. The exposure was chorioamnionitis, and secondarily, its estimated duration. The composite outcome included pneumonia, seizure, necrotizing enterocolitis, sepsis, periventricular/intraventricular/cerebral hemorrhage, mechanical ventilation, and neonatal death. Multivariable logistic regression with generalized estimating equations was used, stratified by gestational age at delivery.

Results

Among 221,274 deliveries, the odds of the neonatal adverse outcome <34 weeks was 2-fold higher among infants exposed to chorioamnionitis vs. those who were not (62.0 vs. 47.7%; AOR: 1.86; 95%CI: 1.25–2.75), and was ~3.5-fold higher ≥34 weeks (9.2 vs. 2.5%; AOR: 3.34; 95% CI: 2.35–4.76). The estimated duration of chorioamnionitis did not change the above associations.

Conclusions

Chorioamnionitis was associated with an approximately 2- and 3.5-fold increased odds of neonatal adverse outcomes <34 and ≥34 weeks, respectively, regardless of its estimated duration.

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Change history

  • 07 March 2019

    This correction is to acknowledge that funding was supported by the Intramural Research Program of the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The Consortium on Safe Labor was funded by the Intramural Research Program of the NICHD, through Contract No. HHSN267200603425C.

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Acknowledgements

This study was funded by the Intramural Research Program of the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The Consortium on Safe Labor was funded by the Intramural Research Program of the NICHD, through Contract No. HHSN267200603425C. Intramural investigators designed the study and data were collected by clinical site investigators. The corresponding author has full access to the data and final responsibility for preparation and submission of the paper for publication.

Institutions involved in the Consortium include, in alphabetical order: Baystate Medical Center, Springfield, MA; Cedars-Sinai Medical Center Burnes Allen Research Center, Los Angeles, CA; Christiana Care Health System, Newark, DE; Georgetown University Hospital, MedStar Health, Washington, DC; Indiana University Clarian Health, Indianapolis, IN; Intermountain Healthcare and the University of Utah, Salt Lake City, UT; Maimonides Medical Center, Brooklyn, NY; MetroHealth Medical Center, Cleveland, OH; Summa Health System, Akron City Hospital, Akron, OH; The EMMES Corporation, Rockville MD (Data Coordinating Center); University of Illinois at Chicago, Chicago, IL; University of Miami, Miami, FL; and University of Texas Health Science Center at Houston, Houston, TX.

Author contributions

KKV and DMS conceptualized the study. KKV, DMS, BLH, and JMT assisted with study design and analytical methods. KKV and DMS conducted statistical analyses and wrote the manuscript. BLH, WJ, MML, and JMT assisted with data interpretation.

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Authors and Affiliations

  1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA

    Kartik K. Venkatesh & David M. Stamilio

  2. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA

    Wesley Jackson & Mathew M. Laughon

  3. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA

    Brenna L. Hughes

  4. Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA

    John M. Thorp

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  1. Kartik K. Venkatesh
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Correspondence to Kartik K. Venkatesh.

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Venkatesh, K.K., Jackson, W., Hughes, B.L. et al. Association of chorioamnionitis and its duration with neonatal morbidity and mortality. J Perinatol 39, 673–682 (2019). https://doi.org/10.1038/s41372-019-0322-0

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