Maternal chorioamnionitis and long term neurological morbidity in the offspring.

Amir Freud, Tamar Wainstock, Eyal Sheiner, Ron Beloosesky, Laura Fischerd, Daniella Landau, Asnat Walfisch.  Maternal chorioamnionitis & long term neurological morbidity in the offspring.  European Journal of Paediatric Neurology.  In press.

Highlights

•Maternal chorioamnionitis is associated with cerebral palsy in the offspring.

•Maternal chorioamnionitis is not associated with neurologic related hospitalization in the offspring.

•Pregnancies complicated with chorioamnionitis are more likely to end with perinatal mortality.

Abstract

Background

Chorioamnionitis is a common and potentially devastating complication of pregnancy associated with maternal and perinatal adverse outcomes.

Objective

To evaluate a possible association between maternal chorioamnionitis and long-term pediatric neurological morbidity.

Study design

A population-based retrospective cohort analysis was performed comparing the risk of long-term neurological morbidity. Pediatric neurological morbidity evaluated included hospitalizations with neurological morbidity. Kaplan-Meier survival curves were constructed to compare the cumulative neurological morbidity and a Cox regression model was used to control for confounders.

Results

238 622 newborns were included. Of them, 0.5% were born to mothers with chorioamnionitis. 3.1% offspring were hospitalized with a neurological condition. Total neurological morbidity was not significantly more common in the chorioamnionitis group (3.8% vs. 3.1% respectively, OR 1.23, 95%CI 0.9-1.6, p=0.147). However, a significant and independent association was noted between maternal chorioamnionitis and cerebral palsy. (0.5% vs. 0.1%, OR 5.77, 95% CI 2.5-13.0, p=0.001). In a Cox proportional hazards model, controlling for preterm delivery, birthweight, maternal factors and mode of delivery the association between chorioamnionitis and cerebral palsy remained significant (adjusted HR=2.78, 95% CI 1.20-6.43, P=0.016).

Conclusion

Maternal chorioamnionitis is associated with cerebral palsy in the offspring, independently of other birth circumstances such as preterm delivery and birthweight.

Courtesy of:  https://www.mdlinx.com/journal-summaries/pregnancy-cerebral-palsy-outcome-developmental-delay/2019/03/29/7562262?spec=neurology