Histological chorioamnionitis - implication for bacterial colonization, laboratory markers of infection, and early onset sepsis in very-low-birth-weight neonates.

OBJECTIVE The objective of this study was to evaluate the relationship between histological chorioamnionitis and laboratory markers of infection and congenital sepsis in very-low-birth-weight (VLBW) premature neonates. METHOD This study is a retrospective review of laboratory results of VLBW neonates with birth weight less than 1500 g in our neonatal intensive care unit (NICU) in the last 5 years. RESULTS Ninety-nine VLBW neonates had histological chorioamnionitis, and 50 of them further had funisitis. One hundred and sixty-two VLBW neonates did not have chorioamnionitis. The chorioamnionitis group was more likely than the 'no chorioamnionitis' group to have raised C-reactive proteins (23% versus 9.9%; p = 0.006) and neutrophilia (41% versus 4.3%; p < 0.001). White blood cells were more likely to be present in gastric lavage of the former group than the latter group (70% versus 50%; p = 0.002). Ear swab and gastric lavage were more likely to yield positive growth of micro-organisms from the former group than the latter group (34% versus 9.9% and 22% versus 2.7%; p < 0.001 and p < 0.001, respectively). Congenital sepsis proven by positive blood culture was also more likely to occur (3% versus 0%; p = 0.027). Presence of funisitis further increased the likelihood of the above abnormal laboratory results. CONCLUSIONS Histological chorioamnionitis increases the likelihood of having markers of infection, bacterial colonization, and congenital sepsis. Only 3% of histological chorioamnionitis resulted in congenital sepsis confirmed by blood culture.