Histological chorioamnionitis is associated with cerebral palsy in preterm neonates

Objective

To determine the interaction between histological chorioamnionitis and unexplained neonatal cerebral palsy among low birth weight infants.

Study design

We studied 141 preterm infants below 1500 g delivered between 2000 and 2010. Clinical data, neonatal neuroimaging, laboratory results, the histopathological features of the placenta and gastric smear within the first hour of delivery, were evaluated.

Results

Cerebral palsy was detected in 11 out of 141 preterm newborns (7.8%). The incidence of silent histological chorioamnionitis was 33.6% (43 of 128 cases). Chorioamniontis was significantly associated with the risk of unexplained cerebral palsy (p = 0.024). There were also significant correlations between maternal genital infections and chorioamnionitis (p = 0.005), and between maternal infections and a positive smear of neonatal gastric aspirates (p = 0.000). The rate of cesarean section was 67.4% (95 out of 141 deliveries), and elective cesarean section was performed in 68 cases.

Conclusion

Intrauterine exposure to maternal infection was associated with a marked increase in the risk of cerebral palsy in preterm infants.