All issues > Volume 47(2); 2004

Original Article

Korean J Pediatr. 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 HS Jo¹, Beyong Il BI Kim², Chang Won CW Choi², Jun Dong JD Park², Chong Jai CJ Kim³, Jung-Hwan JH 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

Correspondence Beyong Il BI 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.

Keywords :Histologic chorioamnionitis; Respiratory distress syndrome; Chronic lung disease; Preterm infants