The Fetus at Risk: Chorioamnionitis
Histological chorioamnionitis (HCA) is common in extremely preterm births. HCA in very preterm births is associated with a low risk of respiratory distress syndrome (RDS) as the inflammatory stress in HCA promotes fetal maturity. Previous evidence on increased risk of respiratory distress, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), cerebral palsy (CP), and poor neurodevelopmental outcome, compared to gestation controls, has not been uniformly confirmed. Antenatal steroid that decreases the risk of RDS, IVH, NEC, and CP was rarely given in early studies. Clinical CA, defined on the basis of fever, leukocytosis, and local symptoms, represents 10–25% of all HCA cases. Clinical CA is associated with CP in near-term/term pregnancies and additional adverse outcomes in very preterm pregnancies. HCA combined with intrauterine growth restriction or placental perfusion defect strongly associates with neurological problems. Causes and consequences of HCA remain to be studied.
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