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Effect of chorioamnionitis on brain development and injury in premature newborns

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Title: Effect of chorioamnionitis on brain development and injury in premature newborns
Author: Chau, Vann; Poskitt, Kenneth J.; McFadden, Deborah E.; Bowen-Roberts, Tim; Synnes, Anne; Brant, Rollin; Sargent, Michael A.; Soulikias, Wendy; Miller, Steven P.
Subject Keywords Placental infection;White matter injury;Magnetic resonance imaging;Diffusion tensor imaging;Magnetic resonance spectroscopic imaging
Issue Date: 2009
Publicly Available in cIRcle 2010-03-18
Publisher Wiley-Blackwell
Citation: Annals of Neurology, 2009 Aug;66(2):155-64.
Abstract: Objective [ ] The association of chorioamnionitis and non-cystic white matter injury, a common brain injury in premature newborns, remains controversial. Our objectives were to determine the association of chorioamnionitis and postnatal risk factors with white matter injury, and the effects of chorioamnionitis on early brain development, using advanced MR imaging. Methods [ ] Ninety-two preterm newborns (24-32 weeks gestation) were studied at a median age of 31.9 weeks and again at 40.3 weeks gestation. Histopathological chorioamnionitis and white matter injury were scored using validated systems. Measures of brain metabolism (N-acetylaspartate/choline and lactate/choline) on magnetic resonance spectroscopy, and microstructure (average diffusivity and fractional anisotropy) on diffusion tensor imaging were calculated from predefined brain regions. Results [ ] Thirty-one newborns (34%) were exposed to histopathological chorioamnionitis, and 26 (28%) had white matter injury. Histopathological chorioamnionitis was not associated with an increased risk of white matter injury (relative risk: 1.2; P=0.6). Newborns with postnatal infections and hypotension requiring therapy were at higher risk of white matter injury (P<0.03). Adjusting for age at scan and regions of interest, histopathological chorioamnionitis did not significantly affect brain metabolic and microstructural development (P>0.1). In contrast, white matter injury was associated with lower N-acetylaspartate/choline (–8.9%; P=0.009) and lower white matter fractional anisotropy (–11.9%; P=0.01). Interpretation [ ] Histopathological chorioamnionitis does not appear to be associated with an increased risk of white matter injury on magnetic resonance imaging or with abnormalities of brain development. In contrast, postnatal infections and hypotension are associated with an increased risk of white matter injury in the premature newborn. Final published version [ ] Ann Neurol. 2009 Aug;66(2):155-64. URL: http://www3.interscience.wiley.com/journal/76507645/home
Affiliation: Pathology and Laboratory Medicine, Dept ofPediatrics, Dept ofRadiology, Dept ofStatistics, Dept of
URI: http://hdl.handle.net/2429/22124
Peer Review Status: Unreviewed
Scholarly Level: Researcher

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