The Association of Histopathological and Clinical Chorioamnionitis with Neonatal Outcomes

Author(s): Amani Qasem MD, Akanksha Sancheti*, Aashika Janwadkar MD, Manhal Khilfeh MD

Introduction: Chorioamnionitis (CA) is an infection or inflammation of the amniotic fluid, placenta, fetus, fetal membranes, or decidua, often resulting from a bacterial infection. CA occurs in 1-13% of term infants and 30-70% of preterm infants, causing significant neonatal morbidity and long-term complications. It can be diagnosed clinically or through histopathological examination.

Aim: To investigate the relationship between clinical and histopathological CA and their impact on neonatal and maternal outcomes.

Methods: This retrospective cohort study reviewed 393 mother-infant pairs at a NICU hospital from January 1, 2023, to December 31, 2023. Data included maternal and infant clinical characteristics, signs and symptoms of CA, and histopathological examination of placentas. Statistical analyses were conducted using SPSS.

Results: Among 393 pairs, 100 mothers had clinical CA. The mean rupture of membranes (ROM) was significantly longer in these mothers (32.75 hours) compared to those without clinical CA (6.74 hours). Clinical symptoms such as uterine tenderness, fever, tachycardia, and foul-smelling discharge were significant in mothers with clinical CA. Infants of these mothers had higher rates of respiratory distress (45%) and gastrointestinal symptoms (20%). NICU admissions and antibiotic use were more frequent in these infants.

Conclusion: Clinical CA in mothers is associated with poorer neonatal outcomes, including increased respiratory distress and gastrointestinal symptoms. Further research is needed to confirm these findings and explore preventive measures.