Stage III Chorioamnionitis Is Associated with Reduced Risk of Severe Retinopathy of Prematurity

Sugie Manabu; Nobutoshi Nawa; Yusuke Noguchi; Atsuko Taki; Ayako Kashimada; Izumi Honda; Akira Koyama; Kaoru Okazaki; Masatoshi Kondo; Hiroyuki Miyahara; Kazuyuki Ito; Takeru Yamauchi; Tsutomu Kondo; Fumiko Honda-Ozaki; Satoshi Kusuda; Chikako Morioka; Takeo Fujiwara; Tomohiro Morio; Kenichi Kashimada

doi:10.1016/j.jpeds.2024.114085

Stage III Chorioamnionitis Is Associated with Reduced Risk of Severe Retinopathy of Prematurity

J Pediatr. 2024 May 2:114085. doi: 10.1016/j.jpeds.2024.114085. Online ahead of print.

Authors

Sugie Manabu¹, Nobutoshi Nawa², Yusuke Noguchi³, Atsuko Taki³, Ayako Kashimada⁴, Izumi Honda⁵, Akira Koyama⁵, Kaoru Okazaki⁶, Masatoshi Kondo⁶, Hiroyuki Miyahara⁷, Kazuyuki Ito³, Takeru Yamauchi⁷, Tsutomu Kondo⁷, Fumiko Honda-Ozaki³, Satoshi Kusuda⁸, Chikako Morioka³, Takeo Fujiwara², Tomohiro Morio³, Kenichi Kashimada⁹

Affiliations

¹ Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan; Neonatal Intensive Care Unit, Tsuchiura Kyodo General Hospital, 4-1-1, Ohtsuno, Tsuchiura-city, Ibaraki, 300-0028.
² Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
³ Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
⁴ Department of Medical Education Research and Development, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
⁵ Department of Obstetrics and Gynecology, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo, 183-8524, Japan.
⁶ Department of Neonatology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo, 183-8561, Japan.
⁷ Neonatal Intensive Care Unit, Tsuchiura Kyodo General Hospital, 4-1-1, Ohtsuno, Tsuchiura-city, Ibaraki, 300-0028.
⁸ Department of Pediatrics, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, Tokyo 181-8612 Japan; The Neonatal Research Network of Japan (NRNJ), Shinjuku Parktower N30, 3-7-1 Nishishinjuku, Shinjuku-ku, Tokyo.
⁹ Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. Electronic address: kkashimada.ped@tmd.ac.jp.

PMID: 38703992
DOI: 10.1016/j.jpeds.2024.114085

Abstract

Objective: To identify whether histologically confirmed chorioamnionitis (hCAM) is associated with development of retinopathy of prematurity (ROP).

Study design: We retrospectively analyzed two different cohorts. Cohort 1 was the national database of newborns in Japan born at ≤1500g or <32 weeks' gestation (January 2003 through April 2021, n=38,013). Cohort 2 was babies born at <1500g from a single institution in Tsuchiura, Japan, (April 2015 through March 2018, n=118).

Results: For Cohort1, after adjusting for potential confounders, stage III CAM (n=5,554) was associated with lower odds of severe ROP (stage ≥3 or required peripheral retinal ablation) by 14% (odds ratio [OR]: 0.86; 95% confidence interval [CI]: 0.78-0.94]. CAM of stage I (n=3,277) and II (N=4,319) was not associated with the risk of ROP. For Cohort 2, the odds of severe ROP were significantly reduced in moderate to severe hCAM groups (stage II, OR: 0.06, 95% CI: 0.05-0.82; stage III, OR: 0.10, 95% CI: 0.01-0.84). Neonates with funisitis, comorbidity of hCAM, and a finding of fetal inflammatory response had lower odds of severe ROP (OR: 0.11; 95% CI: 0.01-0.93).

Conclusions: After adjusting for confounders, severe hCAM with fetal inflammatory response was associated with reduced risk of ROP.

Keywords: Fetal Programming; Funisitis; UCMSC (umbilical cord mesenchymal stem cell).