[Neonatal morbidity and mortality in very low birth weight infants according to exposure to chorioamnionitis].

OBJECTIVES

To study differences in the incidence of neonatal morbidity and mortality among newborns weighing less than 1,500 g according to exposure to chorioamnionitis (CA).

PATIENTS AND METHODS

A case-control study of 135 newborns weighing less than 1,500 g at birth and born between 1988 and 1998 was performed. The case group was composed of 45 newborns exposed to clinical or subclinical levels of maternal CA. Each newborn in the case group was matched with two controls, both weighing less than 1,500 g, one of them born immediately before and the other one immediately after. Perinatal records, neonatal morbidity and mortality were analyzed.

RESULTS

The mean gestational age was 28.5 weeks (range: 24-38 weeks) with a mean weight of 1,131 g (range: 520-1,500 g). The time of membrane rupture was significantly greater in the case group (176 h vs 57 h; p < 0.001). Forty percent of the cases presented sepsis in the first 72 h of life compared with 10 % of the controls (p < 0.0001). No significant differences in morbidity or mortality were found between the groups, although chronic lung disease (20 % vs 13 %) and intraventricular hemorrhage (24 % vs 17 %) were more frequent in infants exposed to CA. Resuscitation (77.8 % vs 45.6 %; p 0.001) and mechanical ventilation (73 % vs 50 %; p 0.016) were required by a great number of cases than controls.

CONCLUSIONS

The presence of CA was associated with a higher risk of early onset infection and the need for neonatal resuscitation and mechanical ventilation. No significant differences were found in morbidity or mortality.