Influence of perinatal inflammation on the neurodevelopmental outcome of premature infants

J Matern Fetal Neonatal Med. 2019 Apr;32(7):1069-1077. doi: 10.1080/14767058.2017.1399118. Epub 2017 Nov 16.

Abstract

Objective: To evaluate the influence of perinatal inflammation on neurodevelopmental outcome of premature infants.

Study design: From a retrospective cohort study of women with preterm labor with intact membranes or preterm prelabor rupture of membranes (PPROM) with an amniocentesis to rule out intra-amniotic inflammation (IAI) and microbial invasion of the amniotic cavity (MIAC), we evaluated neurodevelopmental outcome of their infants born between 24.0 and 34.0 weeks gestation. Women with clinical chorioamnionitis at admission were excluded. Neurodevelopmental outcome was screened with the Ages & Stages Questionnaire (ASQ)-3. We analyzed the relationship between an altered ASQ-3 and antenatal, intra-partum and post-partum factors related to perinatal inflammation.

Result: Among 98 infants evaluated, 22% had an abnormal score. Amniotic fluid interleukin-6 levels and early-onset sepsis (EOS) were independent factors of an altered ASQ-3 with delivery <26.0 weeks being the strongest predictor.

Conclusions: In premature infants, the presence of IAI, delivery <26.0 weeks and EOS were found to be independent factors of an altered ASQ-3.

Keywords: Infants; outcomes; women.

MeSH terms

  • Adult
  • Amniocentesis
  • Amniotic Fluid / chemistry*
  • Amniotic Fluid / microbiology*
  • Bacteria / isolation & purification
  • Chorioamnionitis / physiopathology*
  • Cohort Studies
  • Female
  • Fetal Membranes, Premature Rupture / physiopathology
  • Gestational Age
  • Humans
  • Infant, Premature / growth & development*
  • Interleukin-6 / analysis
  • Neurodevelopmental Disorders / epidemiology*
  • Obstetric Labor, Premature
  • Parturition
  • Pregnancy
  • Premature Birth / physiopathology*
  • Retrospective Studies
  • Yeasts / isolation & purification

Substances

  • Interleukin-6