Kartik K Venkatesh, Alan Leviton, Jonathan L Hecht, Robert M Joseph, Laurie M Douglass, Jean A Frazier, Julie L Daniels, Rebecca C Fry, T Michael O’Shea, Karl C K Kuban
Am J Obstet Gynecol. 2020 Nov;223(5):745.e1-745.e10.
We investigated ass’n between histo chorioamnionitis (CA) & neurodevelopmental (ND) impairment at 10 yrs among children born EP. CA defined by histo stage (early, mod, advanced) and grade (mild/mod, severe) of chorionic plate & umbilical cord inflammation. Children examined for CP, ASD, Cog I, & epilepsy at 10 yrs. Among 805 placentas, 43% (347/805) had histo CA by mod or adv mat stage, 36% (286/805) by severe mat grade, 18% (132/737) by mod or adv fetal stage, and 1% (10/737) by severe fetal grade. Impairment frequencies were 11% (88/767) for CP, 7% (56/773) for ASD, 15% (120/788) for CogI, and 7% (52/763) for epilepsy. Adj OR for association between histo CA & CP was increased with advanced mat stage (adj OR, 2.5; 95% CI, 1.6-3.9), severe mat grade (adj OR, 2.0; 95% CI, 1.2-3.4), mod fetal stage (adj OR, 2.20; 95% CI, 2.1-2.2), and mild or mod fetal grade (adj OR, 1.5; 95% CI, 1.0-2.2). Similarly, adj OR for association between histo CA and epilepsy was increased with advanced mat stage (adj OR, 1.5; 95% CI, 1.3-1.6) and severe fetal grade (adj OR, 5.9; 95% CI, 1.9-17.8). Adj OR for association between histo CA and ASD was increased with mild or mod fetal grade (adj OR, 1.7; 95% CI, 1.0-2.9). Histo CA not associated with CogI. Findings held after adj for delivery GA. In contrast to histo CA, a clinical dx of CA is not associated with ND impairment.