Frontiers in Pediatrics (Apr 2014)
Clinical Dilemma of Positive Histologic Chorioamnionitis in Term Newborn
Abstract
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 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% CI 1.6-4.2, p Conclusions: Although HCA in term infants is associated with EOCS, it didn’t improve the ability of C-reactive protein and immature to total neutrophil ratio to predict EOCS. Routine placental examination may not contribute to the diagnosis of EOCS in term infants.
Keywords