Corioamnionitis clínica y riesgo de hemorragia intraventricular grave en recién nacidos [Less-Than or Equal To]28 semanas de gestación/Clinical chorioamnionitis and the risk of severe intraventricular hemorrhage in newborn babies born [Less-Than or Equal To]28 weeks gestation

• Published in: Acta pediátrica española Vol. 69; no. 11; p. 490
• Main Authors: Gracia, S Rite, Martín, C Ruiz de Ia Cuesta, Moisés, V Rebage, Pérez, D Royo, Pisón, R Pinillos, Montejo, A Romo, Montañés, S Rite
• Format: Journal Article
• Language: Spanish
• Published: Madrid Ediciones Mayo 01.12.2011
• Subjects: Brain damage; Effects; Hemorrhage; Newborn babies
• ISSN: 0001-6640; 2014-2986

There is increasing evidence that the premature newborns are particularly vulnerable to adverse effects of chorioamnionitis. The fetal inflammatory response to the infection is associated with an increased incidence of brain injury in this population. To analyze if the clinical chorioamnionitis is associated with an increased risk of developing severe intraventricular hemorrhage (IVH) (grade III-IV) in the most immature preterm newborns in the first 72 hours of life. We retrospectively reviewed all preterm newborns delivered at ≤28 weeks of gestation after spontaneous onset of preterm labor or preterm membrane rupture during the period July 2006-February 2009 (117 preterm newborns were included). Prenatal, perinatal and clinical evolution data were compared between the group with severe IVH diagnosed in the first 72 hours of life and the group without this complication. Statistical methods included t student test and U Mann-Whitney test for quantitative variables and χ^sup 2^ test and odds ratio (OR) estimation for qualitative variables. Finally, a logistic regression analysis was performed to evaluate the independent relationship among significant variables at univariate analysis. Severe IVH group had a significant lower gestational age. The group with severe IVH and that without severe IVH was not significantly different in birth weight, 1 and 5 minute apgar scores and caesarean delivery. Newborns with severe IVH require in the first 12 hours of life intubation and significant higher oxygen and inotropic drugs requirements (p <0.05). A lower base excess in the first 12 hours was associated with an increased risk of severe IVH in this population (p= 0.001). Among the prenatal variables an independent association between clinical chorioamnionitis and severe IVH was found (OR: 2.66; CI 95%: 1.14-6.21). Maternal chorioamnionitis increases the risk of developing severe IVH among preterm newborns delivered at ≤ 28 weeks of gestation.