Chorioamnionitis in the pathogenesis of brain injury in preterm infants

Vann Chau; Deborah E McFadden; Kenneth J Poskitt; Steven P Miller

doi:10.1016/j.clp.2013.10.009

Chorioamnionitis in the pathogenesis of brain injury in preterm infants

Clin Perinatol. 2014 Mar;41(1):83-103. doi: 10.1016/j.clp.2013.10.009. Epub 2013 Dec 12.

Authors

Vann Chau¹, Deborah E McFadden², Kenneth J Poskitt³, Steven P Miller⁴

Affiliations

¹ Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada; University of Toronto, Department of Pediatrics, 563 Spadina Crescent, Toronto, Ontario, M5S 2J7, Canada; Child & Family Research Institute, 950 28th Avenue, Vancouver, British Columbia, V5Z 4H4, Canada. Electronic address: vann.chau@sickkids.ca.
² Child & Family Research Institute, 950 28th Avenue, Vancouver, British Columbia, V5Z 4H4, Canada; Department of Pathology, BC Children's & Women's Health Center, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada; University of British Columbia, Departments of Pediatrics, Pathology and Radiology, 2329 West Mall, Vancouver, British Columbia, V6T 1Z4, Canada.
³ Child & Family Research Institute, 950 28th Avenue, Vancouver, British Columbia, V5Z 4H4, Canada; University of British Columbia, Departments of Pediatrics, Pathology and Radiology, 2329 West Mall, Vancouver, British Columbia, V6T 1Z4, Canada; Departments of Pediatrics and Radiology, BC Children's & Women's Health Center, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada.
⁴ Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada; Neurosciences and Mental Health Program, Research Institute, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada; University of Toronto, Department of Pediatrics, 563 Spadina Crescent, Toronto, Ontario, M5S 2J7, Canada; Child & Family Research Institute, 950 28th Avenue, Vancouver, British Columbia, V5Z 4H4, Canada.

PMID: 24524448
DOI: 10.1016/j.clp.2013.10.009

Abstract

Chorioamnionitis (or placental infection) is suspected to be a risk factor for brain injury in premature infants. The suggested association between chorioamnionitis and cystic periventricular leukomalacia and cerebral palsy is uncertain because of the variability of study designs and definitions of chorioamnionitis. Improvements in neonatal intensive care may have attenuated the impact of chorioamnionitis on brain health outcomes. Large multicenter studies using rigorous definitions of chorioamnionitis on placental pathologies and quantitative magnetic resonance techniques may offer the optimal way to clarify the complex role of chorioamnionitis in modifying brain health and long-term outcomes.

Keywords: Cerebral palsy; Diffusion tensor imaging; Magnetic resonance imaging; Magnetic resonance spectroscopic imaging; Neurodevelopment; Placental infection; White matter injury.

Publication types

Review

MeSH terms

Brain Injuries / etiology
Brain Injuries / immunology
Brain Injuries / physiopathology*
Cerebral Palsy / etiology
Cerebral Palsy / immunology
Cerebral Palsy / physiopathology*
Chorioamnionitis / immunology
Chorioamnionitis / physiopathology*
Cytokines / immunology
Female
Fetal Diseases / etiology
Fetal Diseases / immunology
Fetal Diseases / physiopathology*
Humans
Infant, Newborn
Infant, Premature
Inflammation Mediators / immunology
Leukomalacia, Periventricular / etiology
Leukomalacia, Periventricular / immunology
Leukomalacia, Periventricular / physiopathology*
Nerve Fibers, Myelinated / immunology*
Pregnancy
Systemic Inflammatory Response Syndrome / etiology
Systemic Inflammatory Response Syndrome / immunology
Systemic Inflammatory Response Syndrome / physiopathology*

Substances

Cytokines
Inflammation Mediators