Observational studyPloS one2019
Impact of different stages of intrauterine inflammation on outcome of preterm neonates: Gestational age-dependent and -independent effect.
Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Histological Chorioamnionitis and Funisitis as New Risk Factors for Retinopathy of Prematurity: A Meta-analysis.American journal of perinatology · 2024Pooled it
- Inflammatory Indices in Preterm Infants with Hemodynamically Significant Patent Ductus Arteriosus: Early Postnatal Patterns and Treatment Response.Children (Basel, Switzerland) · 2026Article
- Impact of placental pathology on the risk of bronchopulmonary dysplasia in preterm infants: The role of gestational age and sex.European journal of pediatrics · 2025Observational
- The effect of histological and subclinical chorioamnionitis and funisitis on breathing effort in premature infants at birth: a retrospective cohort study.European journal of pediatrics · 2024Article
- Cytokine and growth factor correlation networks associated with morbidities in extremely preterm infants.BMC pediatrics · 2024Article
- Risk factors for and short-term prognosis of intrauterine infection in preterm infants.The Journal of international medical research · 2024Article
- The influence of chorioamnionitis on respiratory drive and spontaneous breathing of premature infants at birth: a narrative review.European journal of pediatrics · 2024Review
- Association of Funisitis with Short-Term Outcomes of Prematurity: A Frequentist and Bayesian Meta-Analysis.Antioxidants (Basel, Switzerland) · 2023Review
- The Association of Patent Ductus Arteriosus with Inflammation: A Narrative Review of the Role of Inflammatory Biomarkers and Treatment Strategy in Premature Infants.International journal of molecular sciences · 2022Review
- Risk factors and bronchopulmonary dysplasia severity: data from the Spanish Bronchopulmonary Dysplasia Research Network.European journal of pediatrics · 2022Observational
- Exposure to intrauterine inflammation and late-onset sepsis in very preterm infants.Pediatric research · 2022Article
- Angiographic Review of Choroidal Involution in Eyes with Retinopathy of Prematurity Treated with Bevacizumab.Ophthalmic research · 2022Article
- Adverse Maternal and Neonatal Outcomes in Women With Elevated Intrapartum Temperature Complicated by Histological Chorioamnionitis at Term: A Propensity-Score Matched Study.Frontiers in pediatrics · 2021Article
- Earlier preterm birth is associated with a worse neurocognitive outcome in a rabbit model.PloS one · 2021Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the impact of different stages of intrauterine inflammation (IUI) on neonatal outcomes, before and after adjusting for gestational age (GA) and other perinatal confounders.
methodsThis was an observational, prospective, single-center cohort study including all eligible neonates with GA < 35 weeks and/or birth weight ≤ 1500 g born at a 3rd level Neonatal Intensive Care Unit between 2011 and 2014. Pathological patterns of placenta, membranes and cord were classified according to Redline's criteria. Multivariable linear and logistic regression models were applied, either including or not GA among the covariates.
resultsOf the 807 enrolled neonates, 134 (16.6%) had signs of IUI: among these, 54.5% showed just histological chorioamnionitis (HCA), 25.4% had HCA + funisitis (FUN) stage 1, and 20.1% had HCA + FUN stage 2-3. At univariate analysis, HCA increased the risk for retinopathy of prematurity (ROP) and bronchopulmonary dysplasia, while FUN (any stage) had a deleterious impact on all outcomes investigated. After adjustment for covariates not including GA, HCA was a risk factor only for ROP (OR = 2.8, CI: 1-7.8), while FUN (any stage) was still associated with increased ORs for all outcomes (p <0.01). Upon inclusion of GA in the regression model, the results differed remarkably. HCA was associated with lower risk for mechanical ventilation (OR = 0.3, CI: 0.1-0.7) and need for surfactant (OR = 0.5, CI: 0.2-0.9), while FUN (any stage) worsened clinical conditions at birth (p <0.05), increased the risk for early-onset sepsis (p <0.01), and increased the length of mechanical ventilation (FUN stage 2-3 only, RC = 6.5 days, CI: 2-11). No other outcome was affected.
conclusionsIUI, especially FUN, negatively impact most neonatal morbidities, but its effect is partially reverted adjusting for GA. Considered that GA is an intermediate variable interposed between prenatal causes of prematurity and outcomes, the appropriateness of adjusting for GA may be questionable.
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