1. Association of Chorioamnionitis with Cerebral Palsy at Two Years after Spontaneous Very Preterm Birth: The EPIPAGE-2 Cohort Study
- Author
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Stéphane Marret, Jennifer Zeitlin, Barthélémy Tosello, Claude D'Ercole, Caroline Diguisto, Catherine Arnaud, Norbert Winer, Damien Subtil, RM Isabelle Monier, Laurence Foix L'Helias, Véronique Pierrat, Andrei S. Morgan, Mathilde Letouzey, Bruno Langer, François Goffinet, Héloïse Torchin, Catherine Gire, Thomas Schmitz, Pascal Boileau, Emeline Maisonneuve, Christophe Vayssière, Pierre-Yves Ancel, Louise Devisme, Julie Blanc, Loïc Sentilhes, Géraldine Gascoin, Thomas Desplanches, Florence Bodeau-Livinec, Aurélie Garbi, Jean-Christophe Rozé, Pierre Delorme, Gilles Kayem, Chloé Arthuis, Elsa Lorthe, Thierry Debillon, Instituto de Saúde Pública da Universidade do Porto, Sorbonne Université (SU), Université Paris Descartes - Paris 5 (UPD5), Maladies RAres du DEveloppement embryonnaire et du MEtabolisme : du Phénotype au Génotype et à la Fonction - ULR 7364 (RADEME), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de pédiatrie néonatale et réanimation - neuropédiatrie [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Hôpital Jeanne de Flandre [Lille], Université de Bordeaux (UB), Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Hôpital Charles Nicolle [Rouen]-CHU Rouen, and Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille
- Subjects
Male ,Cerebral palsy CP ,medicine.medical_specialty ,Fetal Membranes, Premature Rupture ,Time Factors ,[SDV]Life Sciences [q-bio] ,Population ,Chorioamnionitis ,Cerebral palsy ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,030225 pediatrics ,Cause of Death ,medicine ,cohort study ,Very Preterm Birth ,Humans ,030212 general & internal medicine ,Prospective Studies ,education ,education.field_of_study ,cerebral palsy ,Obstetrics ,business.industry ,Cerebral Palsy ,Gestational age ,Infant ,preterm birth ,medicine.disease ,chorioamnionitis ,3. Good health ,intrauterine infection ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Gestation ,Premature Birth ,Female ,business ,Premature rupture of membranes ,Infant, Premature ,Cohort study - Abstract
Objective To assess whether chorioamnionitis is associated with cerebral palsy (CP) or death at 2 years' corrected age in infants born before 32 weeks of gestation after spontaneous birth. Study design EPIPAGE-2 is a national, prospective, population-based cohort study of children born preterm in France in 2011; recruitment periods varied by gestational age. This analysis includes infants born alive after preterm labor or preterm premature rupture of membranes from 240/7 to 316/7 weeks of gestation. We compared the outcomes of CP, death at 2 years' corrected age, and “CP or death at age 2” according to the presence of either clinical chorioamnionitis or histologic chorioamnionitis. All percentages were weighted by the duration of the recruitment period. Results Among 2252 infants born alive spontaneously before 32 weeks of gestation, 116 (5.2%) were exposed to clinical chorioamnionitis. Among 1470 with placental examination data available, 639 (43.5%) had histologic chorioamnionitis. In total, 346 infants died before 2 years and 1586 (83.2% of the survivors) were evaluated for CP at age 2 years. CP rates were 11.1% with and 5.0% without clinical chorioamnionitis (P = .03) and 6.1% with and 5.3% without histologic chorioamnionitis (P = .49). After adjustment for confounding factors, CP risk rose with clinical chorioamnionitis (aOR 2.13, 95% CI 1.12-4.05) but not histologic chorioamnionitis (aOR 1.21, 95% 0.75-1.93). Neither form was associated with the composite outcome “CP or death at age 2.” Conclusions Among infants very preterm born spontaneously, the risk of CP at a corrected age of 2 years was associated with exposure to clinical chorioamnionitis but not histologic chorioamnionitis.
- Published
- 2020