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Effect of chorioamnionitis on brain development and injury in premature newborns

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dc.contributor.author Chau, Vann
dc.contributor.author Poskitt, Kenneth J.
dc.contributor.author McFadden, Deborah E.
dc.contributor.author Bowen-Roberts, Tim
dc.contributor.author Synnes, Anne
dc.contributor.author Brant, Rollin
dc.contributor.author Sargent, Michael A.
dc.contributor.author Soulikias, Wendy
dc.contributor.author Miller, Steven P.
dc.date.accessioned 2010-03-18T23:55:02Z
dc.date.available 2010-03-18T23:55:02Z
dc.date.issued 2009
dc.identifier.citation Annals of Neurology, 2009 Aug;66(2):155-64. en
dc.identifier.uri http://hdl.handle.net/2429/22124
dc.description.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 en
dc.language.iso eng en
dc.publisher Wiley-Blackwell en
dc.subject Placental infection en
dc.subject White matter injury en
dc.subject Magnetic resonance imaging en
dc.subject Diffusion tensor imaging en
dc.subject Magnetic resonance spectroscopic imaging en
dc.title Effect of chorioamnionitis on brain development and injury in premature newborns en
dc.type text en
dc.type still image en
dc.type.text article en
dc.description.affiliation Pathology and Laboratory Medicine, Dept of en
dc.description.affiliation Pediatrics, Dept of en
dc.description.affiliation Radiology, Dept of en
dc.description.affiliation Statistics, Dept of en
dc.description.reviewstatus Unreviewed en
dc.rights.copyright Annals of Neurology (Wiley-Blackwell) en
dc.description.scholarlevel Researcher en


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