Abstract 6
Intrauterine infection(IUI) appears to increase the risk of preterm delivery, intraventricular haemorrhage, neonatal white matter damage, and subsequent cerebral palsy. Our recent observations indicate that brain cortex morphogenesis is significantly impaired in fetuses spontaneously aborted for extensive ascending histological chorioamnionitis (HCA). The purpose of the present study was to assess the relations between HCA, maternal clinical signs of IUI, and early neonatal neurological outcome. A total of 292 singleton infants, free of known congenital abnormalities were examined in a longitudinal prospective study (M: 141, F: 151; gestational age, M±SD, 36.06±5.16wk, range: 24-42; birth weight 2467±1029 gr). The infants were divided into three groups, on the basis of the clinical and placental findings: a) HCA with clinical signs; B) HCA without clinical signs; and C) controls. Differences between groups were evaluated using the χ2 statistics, Fisher's test, Mann-Whitney's U, or Kruskal-Wallis analysis of variance as appropriate. Thirty infants (M: 12, F: 18) were assigned to group A, 77 (M: 42, F: 35) to B, and 185 (M: 87, F: 98) to C, respectively. Differences between the groups included: gestation <32 wk (A: 63.3%, B: 32.47%, C: 10.27, p<0.001; A vs B, p<0.01); intraventricular haemorrhage, degree >=3 (all infants: 30%, 22.1%, 3.28%, p<0.01; term: 14.29%, 2.04%, 0%, p<0.01; preterm: 34.78%, 57.14%, 17.14%, p<0.01); ventriculomegaly (all: 13.33%, 9.09%, 1.08%, p<0.01; T: 14.3%, 2.04%, 0.7%, p<0.01; PT: 13.04%, 21.43%, 2.86%, p<0.05), and increased echodensity in the periventricular regions (all: 16.67%, 15.58%, 2.16%, p<0.01; T: 14.19%, 6.12%, 1.33%, p<0.05; PT: 17.39%, 32.14%, 5.17%, p<0.05). These findings indicate that IUI is significantly related to brain injury in the developing brain and to adverse early neonatal neurological outcome.
