Clinical dilemma of positive histologic chorioamnionitis in term newborn

Alain Cuna, Laleh Hakima, Yun An Tseng, Bianca Fornier, Shahidul Islam, Maria Lyn Quintos-Alagheband, Poonam Khullar, Barry Weinberger, Nazeeh Hanna

Research output: Contribution to journalArticle

17 Citations (Scopus)

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 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.

Original languageEnglish (US)
Article number27
JournalFrontiers in Pediatrics
Volume2
Issue numberAPR
DOIs
StatePublished - Apr 1 2014
Externally publishedYes

Fingerprint

Chorioamnionitis
Sepsis
Newborn Infant
Nurseries
Neonatal Intensive Care Units
C-Reactive Protein
Neutrophils
Premature Infants

Keywords

  • Infection
  • Newborn
  • Placental examination

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Cuna, A., Hakima, L., Tseng, Y. A., Fornier, B., Islam, S., Quintos-Alagheband, M. L., ... Hanna, N. (2014). Clinical dilemma of positive histologic chorioamnionitis in term newborn. Frontiers in Pediatrics, 2(APR), [27]. https://doi.org/10.3389/fped.2014.00027

Clinical dilemma of positive histologic chorioamnionitis in term newborn. / Cuna, Alain; Hakima, Laleh; Tseng, Yun An; Fornier, Bianca; Islam, Shahidul; Quintos-Alagheband, Maria Lyn; Khullar, Poonam; Weinberger, Barry; Hanna, Nazeeh.

In: Frontiers in Pediatrics, Vol. 2, No. APR, 27, 01.04.2014.

Research output: Contribution to journalArticle

Cuna, A, Hakima, L, Tseng, YA, Fornier, B, Islam, S, Quintos-Alagheband, ML, Khullar, P, Weinberger, B & Hanna, N 2014, 'Clinical dilemma of positive histologic chorioamnionitis in term newborn', Frontiers in Pediatrics, vol. 2, no. APR, 27. https://doi.org/10.3389/fped.2014.00027
Cuna, Alain ; Hakima, Laleh ; Tseng, Yun An ; Fornier, Bianca ; Islam, Shahidul ; Quintos-Alagheband, Maria Lyn ; Khullar, Poonam ; Weinberger, Barry ; Hanna, Nazeeh. / Clinical dilemma of positive histologic chorioamnionitis in term newborn. In: Frontiers in Pediatrics. 2014 ; Vol. 2, No. APR.
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