Risk of brain damage in premature infants under 34 weeks of gestational age exposed to histological chorioamnionitis, Lima, Peru

Authors

  • Noelia Guillén Universidad Peruana Cayetano Heredia, Lima, Perú. Médica
  • Carolina Llerena Universidad Peruana Cayetano Heredia, Lima, Perú. Médica
  • Susan Samalvides Universidad Peruana Cayetano Heredia, Lima, Perú. neuróloga/o pediatra
  • Judith Vila Universidad Peruana Cayetano Heredia, Lima, Perú. Hospital Cayetano Heredia, Lima, Perú. neuróloga/o pediatra
  • Tania Juárez Hospital Cayetano Heredia, Lima, Perú. neuróloga/o pediatra
  • Jaime Cáceres Hospital Cayetano Heredia, Lima, Perú. patólogo
  • Daniel Guillén-Pinto Universidad Peruana Cayetano Heredia, Lima, Perú. Hospital Cayetano Heredia, Lima, Perú. neuróloga/o pediatra

DOI:

https://doi.org/10.17843/rpmesp.2020.372.4779

Keywords:

Histological Chorioamnionitis, Preterm, Intraventricular Hemorrhage, White Matter, Periventricular Leucomalacia, Lenticulostriate Vasculopathy, Neurology, Neonatology

Abstract

Objectives: To assess the risk of brain damage in premature infants under 34 weeks of gestational age exposed to histological chorioamnionitis (HCA). Materials and methods: A cohort study was conducted at the Hospital Cayetano Heredia, during 2015. Premature infants under 34 weeks of gestational age, who had histopathological examination of the placenta, were included. The types of HCA evaluated were sub-chorionitis, chorionitis, chorioamnionitis, with or without funisitis. Brain damage was evaluated in three age periods, between 0 and 7 days, between 7 and 30 days and at 40 weeks of corrected gestational age. A neurological follow-up and regular controls were performed with brain ultrasound. Results: A total of 85 premature infants were included, 47.1% were women and the mean gestational age was 30.9 weeks. From the total, 42% (36/85) were born exposed to HCA. Premature rupture of membranes was the main cause of sepsis, which was related to neurological damage. HCA was associated with intraventricular hemorrhage (IVH) during the first week and with white matter lesions between 7 and 30 days of age (p = 0.035). The chorioamnionitis type of HCA was associated with neurological damage during the first week (RR = 2.11, 95% CI: 1.09-4.11) and between 7 and 30 days of age (RR = 2.72, 95% CI: 1.07-6.88). Conclusions: Chorioamnionitis was a risk factor for developing brain injuries in premature infants under 34 weeks of gestational age. It was also a risk factor for HIV during the first 7 days and for white matter injuries between 7 and 30 days of age. At 40 weeks of corrected gestational age, extreme premature infants with HCA had more extensive brain damage.

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Author Biographies

  • Noelia Guillén, Universidad Peruana Cayetano Heredia, Lima, Perú. Médica

    - Medico Cirujano Egresada de la Universidad Peruana Cayetano Heredia

    - Médico Serumista en Villa Rica - Oxapampa - Pasco

    - Médico Residente de Pediatría, Hospital La Paz, Madrid - España

  • Carolina Llerena, Universidad Peruana Cayetano Heredia, Lima, Perú. Médica
    Medico Residente de Pediatría
  • Susan Samalvides, Universidad Peruana Cayetano Heredia, Lima, Perú. neuróloga/o pediatra
    Neuróloga Pediatra
  • Judith Vila, Universidad Peruana Cayetano Heredia, Lima, Perú. Hospital Cayetano Heredia, Lima, Perú. neuróloga/o pediatra
    Neuróloga Pediatra
  • Tania Juárez, Hospital Cayetano Heredia, Lima, Perú. neuróloga/o pediatra
    Neuróloga Pediatra
  • Jaime Cáceres, Hospital Cayetano Heredia, Lima, Perú. patólogo
    Patólogo
  • Daniel Guillén-Pinto, Universidad Peruana Cayetano Heredia, Lima, Perú. Hospital Cayetano Heredia, Lima, Perú. neuróloga/o pediatra

    Neurólogo Pediatra 

    Jefe de Neurología Pediátrica del Hospital Cayetano Heredia, de Lima

    Profesor Principal 

    Universidad Peruana Cayetano Heredia

Published

2020-06-12

Issue

Section

Original Article

How to Cite

1.
Guillén N, Llerena C, Samalvides S, Vila J, Juárez T, Cáceres J, et al. Risk of brain damage in premature infants under 34 weeks of gestational age exposed to histological chorioamnionitis, Lima, Peru. Rev Peru Med Exp Salud Publica [Internet]. 2020 Jun. 12 [cited 2024 Jun. 18];37(2):229-38. Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/4779

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