Document Detail


Clinical dilemma of positive histologic chorioamnionitis in term newborn.
MedLine Citation:
PMID:  24772410     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although histologic chorioamnionitis (HCA) is known to be associated with poor outcomes in preterm infants, its clinical significance among term infants is not clearly known.
OBJECTIVES: To investigate the utility of HCA in determining early onset clinical sepsis (EOCS) among term newborns.
METHODS: The incidence of HCA and EOCS in term infants born during 2008-2009 was evaluated in a single center retrospective study (n = 3417). The predictive value of HCA for determining EOCS in term infants admitted to the neonatal intensive care unit (NICU) for suspected sepsis (n = 388) was quantified. Outcome of otherwise healthy term infants in the nursery with HCA was also investigated.
RESULTS: Overall, 11% of term infants with HCA also had EOCS. HCA was associated with increased risk for EOCS (OR 2.6, 95% confidence interval 1.6-4.2, P < 0.001) among term infants admitted to the NICU for suspected sepsis. No cases of EOCS were found among otherwise well-appearing infants in the nursery with HCA. Multiple logistic regression analysis indicated that addition of HCA does not increase the power of a model combining C-reactive protein (CRP) and immature to total neutrophil ratio in determining EOCS.
CONCLUSION: Although HCA in term infants is associated with EOCS, it did not improve the ability of CRP and immature to total neutrophil ratio to predict EOCS. Routine placental examination may not contribute to the diagnosis of EOCS in term infants.
Authors:
Alain Cuna; Laleh Hakima; Yun-An Tseng; Bianca Fornier; Shahidul Islam; Maria Lyn Quintos-Alagheband; Poonam Khullar; Barry Weinberger; Nazeeh Hanna
Publication Detail:
Type:  Journal Article     Date:  2014-04-04
Journal Detail:
Title:  Frontiers in pediatrics     Volume:  2     ISSN:  2296-2360     ISO Abbreviation:  Front Pediatr     Publication Date:  2014  
Date Detail:
Created Date:  2014-04-28     Completed Date:  2014-04-28     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  101615492     Medline TA:  Front Pediatr     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  27     Citation Subset:  -    
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