Pregnancy Outcomes for 474 Women Whose Pregnancies Were Complicated by Chorioamnion Infection and Neonatal Outcomes for Infants (535 Placentae) After Pregnancies Complicated by Infection, Compared With Those for Whom No Infection Was Identified
| Outcome . | Chorioamnion Infection . | No Chorioamnion Infection . | P Valuea . |
|---|---|---|---|
| Maternal | |||
| No. evaluatedb | 47 | 427 | |
| Maternal age, y | NS | ||
| Mean ± SEM (Range) | 25.0 ± 0.7 (17–38) | 27.8 ± 0.3 (15–43) | |
| Clinical pregnancies, no. | NS | ||
| Mean ± SEM (Range) | 2.2 ± 0.2 (1–5) | 2.5 ± 0.1 (1–11) | |
| Viable offspring from all pregnancies, no. | NS | ||
| Mean ± SEM (Range) | 1.9 ± 0.1 (1–4) | 2.1 ± 0.1 (1–10) | |
| At least 1 sign/symptom of infectionc | 5 (10.6) | 29 (6.8) | NS |
| Cervical incompetence and/or preterm labor | 26 (55.3) | 230 (53.9) | NS |
| Antibiotics administered during labord | 25 (53.2) | 238 (55.7) | NS |
| pPROM | 17 (36.2) | 158 (37.0) | NS |
| Mode of delivery | |||
| Vaginal | 42 (89.4) | 290 (67.9) | .01 |
| Cesarean | 5 (10.6) | 135 (31.6) | NS |
| Undisclosed | 0 (0.0) | 2 (0.5) | NS |
| Neonatal | |||
| No. evaluated | 57 | 478 | |
| Gestational age at delivery, wks | NS | ||
| Mean ± SEM (Range) | 35.7 ± 0.3 (32–41) | 35.6 ± 0.1 (32–41) | |
| Birth weight, g | NS | ||
| Mean ± SEM (Range) | 2642.4 ± 84.6 (1380–3925) | 2658.0 ± 29.8 (1060–4530) | |
| Placental weight, g | NS | ||
| Mean ± SEM (Range) | 441.3 ± 16.2 (199–710.7) | 428.7 ± 5.8 (132–1099) | |
| Histologically confirmed chorioamnionitise | |||
| Overall | 31 (54.4) | 90 (18.8) | <.001 |
| Maternal stage, median (range) | 1.5 (1–3) | 1.0 (1–3) | NS |
| Fetal stage, median (range) | 3.0 (1–3) | 2.5 (1–3) | NS |
| Required CPAP | 12 (21.0) | 48 (10.0) | NS |
| Required oxygen support for >6 h | 12 (21.0) | 43 (9.00) | .009 |
| Diagnosed RDS | 10 (17.5) | 43 (9.00) | NS |
| Length of hospital stay, wks | NS | ||
| Mean ± SEM (Range) | 7.0 ± 1.1 (1–37) | 6.1 ± 0.3 (1–43) | |
| Outcome . | Chorioamnion Infection . | No Chorioamnion Infection . | P Valuea . |
|---|---|---|---|
| Maternal | |||
| No. evaluatedb | 47 | 427 | |
| Maternal age, y | NS | ||
| Mean ± SEM (Range) | 25.0 ± 0.7 (17–38) | 27.8 ± 0.3 (15–43) | |
| Clinical pregnancies, no. | NS | ||
| Mean ± SEM (Range) | 2.2 ± 0.2 (1–5) | 2.5 ± 0.1 (1–11) | |
| Viable offspring from all pregnancies, no. | NS | ||
| Mean ± SEM (Range) | 1.9 ± 0.1 (1–4) | 2.1 ± 0.1 (1–10) | |
| At least 1 sign/symptom of infectionc | 5 (10.6) | 29 (6.8) | NS |
| Cervical incompetence and/or preterm labor | 26 (55.3) | 230 (53.9) | NS |
| Antibiotics administered during labord | 25 (53.2) | 238 (55.7) | NS |
| pPROM | 17 (36.2) | 158 (37.0) | NS |
| Mode of delivery | |||
| Vaginal | 42 (89.4) | 290 (67.9) | .01 |
| Cesarean | 5 (10.6) | 135 (31.6) | NS |
| Undisclosed | 0 (0.0) | 2 (0.5) | NS |
| Neonatal | |||
| No. evaluated | 57 | 478 | |
| Gestational age at delivery, wks | NS | ||
| Mean ± SEM (Range) | 35.7 ± 0.3 (32–41) | 35.6 ± 0.1 (32–41) | |
| Birth weight, g | NS | ||
| Mean ± SEM (Range) | 2642.4 ± 84.6 (1380–3925) | 2658.0 ± 29.8 (1060–4530) | |
| Placental weight, g | NS | ||
| Mean ± SEM (Range) | 441.3 ± 16.2 (199–710.7) | 428.7 ± 5.8 (132–1099) | |
| Histologically confirmed chorioamnionitise | |||
| Overall | 31 (54.4) | 90 (18.8) | <.001 |
| Maternal stage, median (range) | 1.5 (1–3) | 1.0 (1–3) | NS |
| Fetal stage, median (range) | 3.0 (1–3) | 2.5 (1–3) | NS |
| Required CPAP | 12 (21.0) | 48 (10.0) | NS |
| Required oxygen support for >6 h | 12 (21.0) | 43 (9.00) | .009 |
| Diagnosed RDS | 10 (17.5) | 43 (9.00) | NS |
| Length of hospital stay, wks | NS | ||
| Mean ± SEM (Range) | 7.0 ± 1.1 (1–37) | 6.1 ± 0.3 (1–43) | |
Data are no. (%) of subjects, unless otherwise indicated.
Abbreviations: CPAP, continuous positive airway pressure; NS, not significant; PCR, polymerase chain reaction; pPROM, preterm premature rupture of membranes; RDS, respiratory distress syndrome; SEM, standard error of the mean.
a By logistic regression analysis.
b Some women (n = 3) delivered multiple placentae and one placenta was found to be infected, while the other was shown to be uninfected by culture and 16S rRNA PCR. Data from these women with contrasting placental microbiology results were excluded from this analysis.
c Defined as maternal temperature of >38°C, uterine or abdominal tenderness, foul-smelling vaginal discharge, maternal tachycardia (heart rate, >120 beats/minute), or fetal tachycardia (heart rate, >160 beats/minute).
d Data are for antibiotics administered for >3 hours before delivery. The types and doses were not recorded.
e Assessed using tissue sections from each placenta according to criteria set out by Redline et al [34]. Maternal and fetal grades of chorioamnionitis are listed as median and range.
Pregnancy Outcomes for 474 Women Whose Pregnancies Were Complicated by Chorioamnion Infection and Neonatal Outcomes for Infants (535 Placentae) After Pregnancies Complicated by Infection, Compared With Those for Whom No Infection Was Identified
| Outcome . | Chorioamnion Infection . | No Chorioamnion Infection . | P Valuea . |
|---|---|---|---|
| Maternal | |||
| No. evaluatedb | 47 | 427 | |
| Maternal age, y | NS | ||
| Mean ± SEM (Range) | 25.0 ± 0.7 (17–38) | 27.8 ± 0.3 (15–43) | |
| Clinical pregnancies, no. | NS | ||
| Mean ± SEM (Range) | 2.2 ± 0.2 (1–5) | 2.5 ± 0.1 (1–11) | |
| Viable offspring from all pregnancies, no. | NS | ||
| Mean ± SEM (Range) | 1.9 ± 0.1 (1–4) | 2.1 ± 0.1 (1–10) | |
| At least 1 sign/symptom of infectionc | 5 (10.6) | 29 (6.8) | NS |
| Cervical incompetence and/or preterm labor | 26 (55.3) | 230 (53.9) | NS |
| Antibiotics administered during labord | 25 (53.2) | 238 (55.7) | NS |
| pPROM | 17 (36.2) | 158 (37.0) | NS |
| Mode of delivery | |||
| Vaginal | 42 (89.4) | 290 (67.9) | .01 |
| Cesarean | 5 (10.6) | 135 (31.6) | NS |
| Undisclosed | 0 (0.0) | 2 (0.5) | NS |
| Neonatal | |||
| No. evaluated | 57 | 478 | |
| Gestational age at delivery, wks | NS | ||
| Mean ± SEM (Range) | 35.7 ± 0.3 (32–41) | 35.6 ± 0.1 (32–41) | |
| Birth weight, g | NS | ||
| Mean ± SEM (Range) | 2642.4 ± 84.6 (1380–3925) | 2658.0 ± 29.8 (1060–4530) | |
| Placental weight, g | NS | ||
| Mean ± SEM (Range) | 441.3 ± 16.2 (199–710.7) | 428.7 ± 5.8 (132–1099) | |
| Histologically confirmed chorioamnionitise | |||
| Overall | 31 (54.4) | 90 (18.8) | <.001 |
| Maternal stage, median (range) | 1.5 (1–3) | 1.0 (1–3) | NS |
| Fetal stage, median (range) | 3.0 (1–3) | 2.5 (1–3) | NS |
| Required CPAP | 12 (21.0) | 48 (10.0) | NS |
| Required oxygen support for >6 h | 12 (21.0) | 43 (9.00) | .009 |
| Diagnosed RDS | 10 (17.5) | 43 (9.00) | NS |
| Length of hospital stay, wks | NS | ||
| Mean ± SEM (Range) | 7.0 ± 1.1 (1–37) | 6.1 ± 0.3 (1–43) | |
| Outcome . | Chorioamnion Infection . | No Chorioamnion Infection . | P Valuea . |
|---|---|---|---|
| Maternal | |||
| No. evaluatedb | 47 | 427 | |
| Maternal age, y | NS | ||
| Mean ± SEM (Range) | 25.0 ± 0.7 (17–38) | 27.8 ± 0.3 (15–43) | |
| Clinical pregnancies, no. | NS | ||
| Mean ± SEM (Range) | 2.2 ± 0.2 (1–5) | 2.5 ± 0.1 (1–11) | |
| Viable offspring from all pregnancies, no. | NS | ||
| Mean ± SEM (Range) | 1.9 ± 0.1 (1–4) | 2.1 ± 0.1 (1–10) | |
| At least 1 sign/symptom of infectionc | 5 (10.6) | 29 (6.8) | NS |
| Cervical incompetence and/or preterm labor | 26 (55.3) | 230 (53.9) | NS |
| Antibiotics administered during labord | 25 (53.2) | 238 (55.7) | NS |
| pPROM | 17 (36.2) | 158 (37.0) | NS |
| Mode of delivery | |||
| Vaginal | 42 (89.4) | 290 (67.9) | .01 |
| Cesarean | 5 (10.6) | 135 (31.6) | NS |
| Undisclosed | 0 (0.0) | 2 (0.5) | NS |
| Neonatal | |||
| No. evaluated | 57 | 478 | |
| Gestational age at delivery, wks | NS | ||
| Mean ± SEM (Range) | 35.7 ± 0.3 (32–41) | 35.6 ± 0.1 (32–41) | |
| Birth weight, g | NS | ||
| Mean ± SEM (Range) | 2642.4 ± 84.6 (1380–3925) | 2658.0 ± 29.8 (1060–4530) | |
| Placental weight, g | NS | ||
| Mean ± SEM (Range) | 441.3 ± 16.2 (199–710.7) | 428.7 ± 5.8 (132–1099) | |
| Histologically confirmed chorioamnionitise | |||
| Overall | 31 (54.4) | 90 (18.8) | <.001 |
| Maternal stage, median (range) | 1.5 (1–3) | 1.0 (1–3) | NS |
| Fetal stage, median (range) | 3.0 (1–3) | 2.5 (1–3) | NS |
| Required CPAP | 12 (21.0) | 48 (10.0) | NS |
| Required oxygen support for >6 h | 12 (21.0) | 43 (9.00) | .009 |
| Diagnosed RDS | 10 (17.5) | 43 (9.00) | NS |
| Length of hospital stay, wks | NS | ||
| Mean ± SEM (Range) | 7.0 ± 1.1 (1–37) | 6.1 ± 0.3 (1–43) | |
Data are no. (%) of subjects, unless otherwise indicated.
Abbreviations: CPAP, continuous positive airway pressure; NS, not significant; PCR, polymerase chain reaction; pPROM, preterm premature rupture of membranes; RDS, respiratory distress syndrome; SEM, standard error of the mean.
a By logistic regression analysis.
b Some women (n = 3) delivered multiple placentae and one placenta was found to be infected, while the other was shown to be uninfected by culture and 16S rRNA PCR. Data from these women with contrasting placental microbiology results were excluded from this analysis.
c Defined as maternal temperature of >38°C, uterine or abdominal tenderness, foul-smelling vaginal discharge, maternal tachycardia (heart rate, >120 beats/minute), or fetal tachycardia (heart rate, >160 beats/minute).
d Data are for antibiotics administered for >3 hours before delivery. The types and doses were not recorded.
e Assessed using tissue sections from each placenta according to criteria set out by Redline et al [34]. Maternal and fetal grades of chorioamnionitis are listed as median and range.
This PDF is available to Subscribers Only
View Article Abstract & Purchase OptionsFor full access to this pdf, sign in to an existing account, or purchase an annual subscription.
