Evidence map›Paper›PMID 40023378›Full record

ArticleAmerican journal of obstetrics and gynecology2025

Funisitis increases the risk of death or cerebral palsy in extremely preterm infants.

Viral G Jain, Nehal A Parikh, Matthew A Rysavy, Vivek V Shukla, Shampa Saha, Susan Hintz, Alan Jobe, Waldemar A Carlo, Namasivayam Ambalavanan, Eunice Kennedy Shriver NICHD Neonatal Research Network

Abstract readMulticenter Study
In one paragraph

Article in American journal of obstetrics and gynecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Infants ≤24 weeks are not just smaller extremely preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Viral G JainUniversity of Alabama at Birmingham, Birmingham, AL. Electronic address: jain@uab.edu.
Nehal A ParikhPerinatal Institute, Neurodevelopmental Disorders Prevention Center, Cincinnati Children's Hospital and University of Cincinnati College of Medicine, Cincinnati, OH.
Matthew A RysavyUniversity of Texas, Houston, TX.
Vivek V ShuklaUniversity of Alabama at Birmingham, Birmingham, AL.
Shampa SahaRTI International, Research Triangle Park, NC.
Susan HintzStanford University School of Medicine, Stanford, CA.
Alan JobePerinatal Institute, Neurodevelopmental Disorders Prevention Center, Cincinnati Children's Hospital and University of Cincinnati College of Medicine, Cincinnati, OH.
Waldemar A CarloUniversity of Alabama at Birmingham, Birmingham, AL.
Namasivayam AmbalavananUniversity of Alabama at Birmingham, Birmingham, AL.
Eunice Kennedy Shriver NICHD Neonatal Research Network

Funding

Neonatal Research Network Data Coordinating Center (DCC)U10HD036790 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI DAS, ABHIK · 2008 to 2017
$62.3M
YALE UNIVERSITY CLINICAL AND TRANSLATIONAL SCIENCE AWARD PROGRAMUL1RR024139 · NCRR · YALE UNIVERSITY · PI SHERWIN, ROBERT S · 2006 to 2011
$56.8M
UNC CLINICAL AND TRANSLATIONAL SCIENCE AWARD: BPCAUL1RR025747 · NCRR · UNIV OF NORTH CAROLINA CHAPEL HILL · PI RUNGE, MARSCHALL S. · 2008 to 2011
$44.6M
UNIVERSITY OF IOWA CTSA FOR PEDIATRIC RESEARCHUL1RR024979 · NCRR · UNIVERSITY OF IOWA · PI ROSENTHAL, GARY E · 2007 to 2011
$31.8M
CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR025008 · NCRR · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2007 to 2011
$29.0M
Stanford Center for Clinical and Translational Education and Research (SCCTER)UL1UL1RR025744 · NCRR · STANFORD UNIVERSITY · PI GREENBERG, HARRY BERNARD · 2008 to 2011
$22.4M
INDIANA CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE (UL1): BPCAUL1RR025761 · NCRR · INDIANA UNIVERSITY INDIANAPOLIS · PI SHEKHAR, ANANTHA · 2008 to 2011
$21.0M
UNIVERSITY OF UTAH CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCE-UL1: BPCAUL1RR025764 · NCRR · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2008 to 2011
$19.4M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD021385 · NICHD · WAYNE STATE UNIVERSITY · PI SHANKARAN, SEETHA · 1991 to 2015
$8.7M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD027904 · NICHD · WOMEN AND INFANTS HOSPITAL-RHODE ISLAND · PI LAPTOOK, ABBOT R · 1991 to 2015
$8.7M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD034216 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CARLO FONT, WALDEMAR A. · 1996 to 2015
$6.4M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD027853 · NICHD · UNIVERSITY OF CINCINNATI · PI SCHIBLER, KURT R · 1991 to 2015
$6.2M
NCATS NIH HHS KL2 TR003097NCRR NIH HHS UL1 RR024139NCRR NIH HHS UL1 RR024979NCRR NIH HHS UL1 RR025008NCRR NIH HHS UL1 RR025744NCRR NIH HHS UL1 RR025747NCRR NIH HHS UL1 RR025761NCRR NIH HHS UL1 RR025764NHLBI NIH HHS K08 HL171892NICHD NIH HHS U10 HD021364NICHD NIH HHS U10 HD021373NICHD NIH HHS U10 HD021385NICHD NIH HHS U10 HD027851NICHD NIH HHS U10 HD027853NICHD NIH HHS U10 HD027856NICHD NIH HHS U10 HD027871NICHD NIH HHS U10 HD027880NICHD NIH HHS U10 HD027904NICHD NIH HHS U10 HD034216NICHD NIH HHS U10 HD036790NICHD NIH HHS U10 HD040492NICHD NIH HHS U10 HD040689NICHD NIH HHS U10 HD053089NICHD NIH HHS U10 HD053109NICHD NIH HHS U10 HD053119NICHD NIH HHS U10 HD053124NICHD NIH HHS U10 HD068244NICHD NIH HHS U10 HD068263NICHD NIH HHS U10 HD068270NICHD NIH HHS U10 HD068278NICHD NIH HHS U10 HD068284NICHD NIH HHS UG1 HD112093
6 · The paper itself

Abstract

backgroundThe relationship between histological chorioamnionitis (inflammation of fetal membranes) and funisitis (inflammation of umbilical cord), both commonly associated with preterm birth, with subsequent development of cerebral palsy remains controversial.

objectiveTo determine if extremely preterm infants (<27 weeks) exposed to histological chorioamnionitis or funisitis are at a higher risk of death or cerebral palsy compared to those without these exposures. STUDY

designMulticenter cohort study of prospectively collected data of preterm infants in the National Institute of Child Health and Development Neonatal Research Network. Infants born 2012 to 2019 who were 22 to 26 MAIN OUTCOMES AND MEASURES: The primary outcome was the composite outcome of death or cerebral palsy defined by the Amiel-Tison standardized exam and Gross Motor Function Classification System ≥1 at 22 to 26 months corrected age.

resultsA total of 6949 infants met the eligibility criteria. Of these, 3971 (57%) infants had histological chorioamnionitis, and 2978 (43%) did not have histological chorioamnionitis. About 90% (6248/6949) of infants had follow-up and complete cerebral palsy data. Similarly, 1057 (28%) infants had funisitis, and 2689 (72%) did not have funisitis. Of these, primary outcome data were available for 87% (3267/3746) infants. On multivariable analysis, histological chorioamnionitis was not associated with death or cerebral palsy (relative risk: 0.98 [95% confidence interval: 0.91, 1.05]). Exposure to funisitis was associated with a higher risk of death or cerebral palsy (relative risk: 1.09 [1.01, 1.21]) that was primarily mediated by preterm birth. There was a higher risk of cerebral palsy among surviving infants exposed to funisitis (relative risk: 1.23 [1.04, 1.51]) compared to those without funisitis. This association was partially (40%) mediated by preterm birth (relative risk: 1.08 [1.05, 1.12]), but the major effect (60%) appears to be a direct adverse effect of funisitis exposure on cerebral palsy development (relative risk: 1.13 [0.97, 1.40]).

conclusionFunisitis was associated with an increased risk of the combined outcome of death or cerebral palsy. In surviving infants, the direct adverse effects of funisitis appear to lead to cerebral palsy, independent of preterm birth.

Indexed as

Cerebral PalsyChorioamnionitisInfant, Extremely PrematureCohort StudiesFemaleGestational AgeHumansInfantInfant, NewbornMalePregnancyProspective StudiesRisk Factorsbayleyfetal inflammatory responsefetal inflammatory response syndromehistological chorioamnionitismaternal inflammatory responseneurodevelopmentneurodevelopmental impairmentneuroinflammationplacenta

Identifiers

PMID40023378
PMCPMC12353965

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