Histologic chorioamnionitis and respiratory outcome in preterm infants

Abstract

A considerable body of human and animal experimental evidence links antenatal inflammation to both accelerated maturation and adverse development of the lung. Initial reports suggest that in preterm infants histologic chorioamnionitis is associated with a decreased incidence of respiratory distress syndrome (RDS), while the incidence of bronchopulmonary dysplasia (BPD) is increased. Considerable variation exists in findings of subsequent human studies, largely dependent on differences in inclusion and exclusion criteria. Taken into account these differences, recent studies generally seem to confirm the effect of chorioamnionitis on RDS incidence, while no effect on BPD is seen. The increased use of antenatal steroids and diminished effects of secondary pro-inflammatory hits seem to explain part of this change. Additional research is needed to explore these complex interactions and their underlying mechanisms, and evaluate long term pulmonary effects of antenatal inflammation.