The Effect of Histologic Chorioamnionitis on the Development of Respiratory Distress Syndrome and Chronic Lung Disease in Preterm Infants

Jo, Heui seung; Kim, Beyong Il; Choi, Chang Won; Park, Jun Dong; Kim, Chong Jai; Choi, Jung-Hwan

Original Article

Korean Journal of Pediatrics 2004;47(2):150-156.
Published online February 15, 2004.

The Effect of Histologic Chorioamnionitis on the Development of Respiratory Distress Syndrome and Chronic Lung Disease in Preterm Infants

Heui seung Jo¹, Beyong Il Kim², Chang Won Choi², Jun Dong Park², Chong Jai Kim³, Jung-Hwan Choi²

¹Department of Pediatrics, College of Medicine, Inje University, Ilsan, Korea
²Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
³Department of Pathology, College of Medicine, Seoul National University, Seoul, Korea

조산아에서 조직학적 융모양막염이 호흡곤란 증후군 및 만성 폐질환의 발병에 미치는 영향

조희승^¹^, 김병일^²^, 최창원^²^, 박준동^²^, 김종재^³^, 최중환^²

^¹인제대학교 의과대학 소아과학교실
^²서울대학교 의과대학 소아과학교실
^³서울대학교 의과대학 병리학교실

Correspondence:
Beyong Il Kim, Email: beyil@snu.ac.kr

Abstract

Purpose
Histologic chorioamnionitis may play a role in the development of respiratory distress syndrome(RDS) and chronic lung disease(CLD) independently or through its association with preterm birth. We investigated the relationship between histologic chorioamnionitis and clinical complications including, RDS and CLD, of preterm infants.
Methods
Clinical data were collected retrospectively from 478 preterm infants(gestational period≤34 weeks) who were admitted to the neonatal intensive care unit(NICU) in Seoul National University Children's Hospital from January 1993 to December 2000.
Results
Histologic chorioamnionitis(CA) was observed in 210 of 478 infants(44%). Lower gestational period was detected in CA(＋) group(31＋1±2＋2 weeks vs. 30＋1±2＋3 weeks). CA(＋) group had decreased incidence of RDS(38.4% vs. 28.1%)[odds ratio, OR 0.35(P=0.0004, 95% confidence intervals, CI 0.19-0.63)], and increased incidence of CLD(7.5% vs. 13.3%)[OR 1.95(P=0.047, 95% CI 1.01-3.79)] combined much more "atypical CLD"(10.5% vs. 55.6%). CA(＋) group had decreased incidence of patent ductus arteriosus(33.3% vs. 25.4%)[OR 0.37(P=0.003, 95% CI 0.19-0.71)]. There was no difference between the two groups in birth weight.
Conclusion
It is suggested that intrauterine infections and fetal inflammatory responses might play a role in the outcome of preterm infants, and histologic chorioamnionitis is an isolated risk factor in the development of RDS and CLD of the preterm infants.

Key Words: Histologic chorioamnionitis, Respiratory distress syndrome, Chronic lung disease, Preterm infants