The Association of Histologic Chorioamnionitis and Bronchopulmonary Dysplasia in Prematurity

Lee, Ji Soo; Choi, Suk Joo; Moon, Sung O; Yang, Soon Ha; Lee, Kyung soon

Abstract

OBJECTIVE
Bronchopulmonary dysplasia (BPD) is one of the most frequent and clinically significant complications of prematurity and it has been widely accepted that immaturity, barotrauma, and oxygen toxicity are major factors in the etiology of BPD. However, recent studies showed that infection may also play a role in the pathogenesis of BPD and exposure to a prenatal inflammatory process may lead to lung injury and predispose to the subsequent development of BPD. The purpose of this study was to test the hypothesis that neonates with BPD had higher incidence of histologic chorioamnionitis than those in whom BPD does not develop.
METHODS
A retrospective study was conducted to examine the relationship between histologic chorioamnionitis and the occurrence of BPD in neonate. We reviewed the hospital charts of 363 women and their neonates whose gestational age at birth were between 24 weeks and 35 weeks and recorded their pregnancy outcomes, the results of placental Biopsy, perinatal outcomes including the occurrence of BPD.
RESULTS
1. Neonates who developed BPD showed higher incidence of acute histologic chorioamnionitis. The relationship remained significant even after the adjustment for gestational age (odds ratio, 3.2: 95% confidence interval, 1.6-11.3: P<0.05). 2. Higher maternal serum CRP was also associated with increased incidence of histologic chorioamnionitis and BPD (P<0.05). 3. Neonates who developed BPD also had higher incidence of infectious morbidity such as early neonatal pneumonia and sepsis (P<0.05).
CONCLUSION
These results suggest that histologic chorioamnionitis is closely related to the occurrence of BPD. This support the hypothesis that intrauterine infection may cause fetal lung injury and subsequent development of BPD.