Histological chorioamnionitis at term according to labor onset: a prospective controlled study

J Perinatol. 2019 Apr;39(4):581-587. doi: 10.1038/s41372-019-0327-8. Epub 2019 Feb 5.

Abstract

Objective: To study the incidence of histological chorioamnionitis (HCA) in term pregnancies according to labor onset.

Study design: During 2013-6, term pregnancy placentas were prospectively sent to histopathology evaluation, and compared between patients with spontaneous onset labor, pre-labor ROM, labor induction and elective cesarean deliveries.

Results: A total of 260 placentas were obtained, 65 from each group. Rates of HCA for the spontaneous labor, PROM, induction and CD groups were: 49, 32, 24 and 4%, respectively (p < 0.001). Composite neonatal outcome was non-significant between the study groups, and between cases with and without HCA. In a logistic regression model, after controlling for parity - gestational age, mode of delivery, ROM > 12 h and spontaneous onset of labor were found to be independent risk factors for HCA.

Conclusion: HCA at term is prevalent in spontaneous labor and supports the association between the inflammatory processes and activation of the physiological signals of parturition.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cesarean Section
  • Chorioamnionitis / epidemiology
  • Chorioamnionitis / pathology*
  • Female
  • Fetal Membranes, Premature Rupture
  • Gestational Age
  • Humans
  • Incidence
  • Infant, Newborn
  • Labor Onset
  • Labor, Induced
  • Labor, Obstetric*
  • Logistic Models
  • Placenta / pathology*
  • Pregnancy
  • Prospective Studies
  • Risk Factors