Histological Inflammatory Responses in the Placenta and Early Neonatal Brain Injury
- 1 September 2008
- journal article
- Published by SAGE Publications in Pediatric and Developmental Pathology
- Vol. 11 (5), 350-354
- https://doi.org/10.2350/07-08-0324.1
Abstract
We investigated the relationship between the severity of histological inflammatory responses in the placenta, chorionic plate, and umbilical cord in conjunction with the intraventricular hemorrhage (IVH) risk in premature infants. Clinical data were prospectively collected for 287 consecutive premature neonates born before 32 completed weeks of gestation and admitted to the level III neonatal intensive care unit of the Department of Pediatrics at Padua University from January 1999 to December 2004. Placental histology for histological chorioamnionitis (HCA) was graded and scored according to Redline and others. The diagnosis of IVH (grades I–IV) was graded according to Volpe's classification. Among the placentas of the 287 preterm examined infants, 68 (23.6%) were diagnosed with acute HCA. Overall incidence of IVH was 11.8%. Of 68 preterm neonates with HCA, 11 developed IVH (16.1%). Maternal HCA at the higher grades and stages increased the risk of IVH: 7 (64%) of the 11 preterm infants with maternal HCA grade 3 developed IVH (RR; 95% CI 2.05; 1.1–3.6) and 8 (73%) of the 11 preterm neonates with stage 3 developed IVH (RR; 95% CI 1.59; 1.0–2.5). Conversely, fetal inflammation was not associated with an increased risk of IVH. In conclusion, the IVH risk in preterm infants at less than 32 gestation weeks is significantly associated with severe grade and stage maternal HCA inflammatory scores.Keywords
This publication has 17 references indexed in Scilit:
- Chorioamnionitis induced by subchorionic endotoxin infusion in sheepAmerican Journal of Obstetrics and Gynecology, 2003
- Increased serum levels of interleukin 6 are associated with severe intraventricular haemorrhage in extremely premature infantsArchives of Disease in Childhood: Fetal & Neonatal, 2003
- Amniotic Infection Syndrome: Nosology and Reproducibility of Placental Reaction PatternsPediatric and Developmental Pathology, 2003
- Early neonatal brain injury in histologic chorioamnionitisThe Journal of Pediatrics, 2001
- The relationship among inflammatory lesions of the umbilical cord (funisitis), umbilical cord plasma interleukin 6 concentration, amniotic fluid infection, and neonatal sepsisAmerican Journal of Obstetrics and Gynecology, 2000
- The Relationship Between Placental and Other Perinatal Risk Factors for Neurologic Impairment in Very Low Birth Weight ChildrenPediatric Research, 2000
- Risk Factors for Neonatal Intraventricular Haemorrhage in Spontaneous Prematurity at 32 Weeks Gestation or LessPlacenta, 2000
- The fetal inflammatory response syndromeAmerican Journal of Obstetrics and Gynecology, 1998
- Maternal Intrauterine Infection, Cytokines, and Brain Damage in the Preterm NewbornPediatric Research, 1997
- Maternal, Placental, and Neonatal Associations with Early Germinal Matrix/Intraventricular Hemorrhage in Infants Born Before 32 Weeks' GestationAmerican Journal of Perinatology, 1995