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Clinical Characteristics and Predictors of Impaired Neonatal Outcomes in Chorioamnionitis at Term Gestation: A cross-sectional cohort study
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  • Patricia Berg ,
  • Michaela Granfors,
  • Charlotta Riese,
  • Ängla Mantel
Patricia Berg
Karolinska Institute

Corresponding Author:patricia.berg@stud.ki.se

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Michaela Granfors
Karolinska Institute Department of Medicine Solna
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Charlotta Riese
Karolinska University Hospital
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Ängla Mantel
Karolinska Institute Department of Medicine Solna
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Abstract

Objective: To describe clinical and laboratory characteristics of term deliveries complicated by chorioamnionitis, and to assess their association with adverse neonatal outcomes. Design: Cross-sectional cohort study Setting: The study is based on data from the Swedish Pregnancy Register, enriched with clinical data extracted from medical charts. Population and Sample: A random sample of 500 term singleton deliveries in Stockholm County with registered diagnosis of chorioamnionitis in the Swedish Pregnancy Register between 2014 and 2020. Methods: Logistic regression was used to estimate odds ratios (OR) as a measurement of the association between clinical and laboratory characteristics and neonatal complications Main Outcome Measures: Neonatal infection and asphyxia-related complications. Results: Maternal fever, maternal and fetal tachycardia, and elevated inflammatory laboratory markers were frequent signs of chorioamnionitis. The prevalence of neonatal infection and asphyxia-related complications was 10 and 22%, respectively. First leukocyte count in the second tertile (OR 2.14 [95% CI 1.02-4.49]), maximum CRP level in the third tertile (OR 4.01 [95% Cl 1.66-9.68]), and positive cervical culture (OR 2.22 [95% Cl 1.10-4.48]) were associated with an increased risk of neonatal infection. Maximum level of CRP in the third tertile (OR 1.93 [95% Cl 1.09-3.41]), and fetal tachycardia (OR 1.63 [95% Cl 1.01-2.65]) were associated with increased risk of asphyxia-related complications. Conclusions: In addition to maternal intrapartum fever, maternal and fetal tachycardia, and elevated inflammatory laboratory markers were common signs of chorioamnionitis. Elevated inflammatory laboratory markers were associated with both neonatal infection and asphyxia-related complications, and fetal tachycardia was associated asphyxia-related complications.
09 Jun 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
17 Jun 2022Submission Checks Completed
17 Jun 2022Assigned to Editor
28 Jun 2022Reviewer(s) Assigned
30 Sep 2022Review(s) Completed, Editorial Evaluation Pending
23 Dec 2022Editorial Decision: Revise Major
20 Jan 20231st Revision Received
23 Jan 2023Submission Checks Completed
23 Jan 2023Assigned to Editor
23 Jan 2023Review(s) Completed, Editorial Evaluation Pending
28 Jan 2023Editorial Decision: Accept