ArticleFrontiers in medicine2026
Association between pathological stages and grades of chorioamnionitis and neonatal myocardial injury: a nested case-control study within a retrospective cohort.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Although chorioamnionitis (CA) is a known risk factor for neonatal complications, the epidemiological links between specific placental inflammatory stages, systemic biomarkers, and neonatal myocardial injury (NMI) remain unclear. Methods: This nested case-control study, derived from a retrospective cohort of 24,175 births, included 942 neonates (314 cases and 628 controls) delivered from 2022 to 2024. Standard and Firth's penalized logistic regression analyses identified independent risk factors for NMI. Predictive performance was evaluated using receiver operating characteristic (ROC) curves, with internal validation performed via the BCa bootstrap method. Model reliability and clinical utility were further assessed using calibration plots and decision curve analysis (DCA), focusing on the optimized Combined model 2. Results: Maternal inflammatory response (MIR) and fetal inflammatory response (FIR) stages and grades were significantly higher in the case group ( Conclusion: Pathological placental MIR stage and grade are potent predictors of NMI. The synergy between PROM, SIRI, and placental inflammation underscores a continuous maternal-fetal inflammatory axis potentially involved in the development of NMI. These internally evaluated multidimensional models provide a robust framework for early risk stratification and targeted intervention for high-risk neonates.
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