Abstract
OBJECTIVES: We compared the relative effect of hypertensive disorders of pregnancy and chorioamnionitis on adverse neonatal outcomes in very preterm neonates, and studied whether gestational age (GA) modulates these effects. METHODS: A cohort of neonates 23 to 30 weeks' GA, born in 2008 to 2011 in 82 hospitals adhering to the Italian Neonatal Network, was analyzed. Infants born from mothers who had hypertensive disorders (N = 2096) were compared with those born after chorioamnionitis (N = 1510). Statistical analysis employed logistic models, adjusting for GA, hospital, and potential confounders. RESULTS: Overall mortality was higher after hypertension than after chorioamnionitis (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.08-1.80), but this relationship changed across GA weeks; the OR for hypertension was highest at low GA, whereas from 28 weeks' GA onward, mortality was higher for chorioamnionitis. For other outcomes, the relative risks were constant across GA; infants born after hypertension had an increased risk for bronchopulmonary dysplasia (OR, 2.20; 95% CI, 1.68-2.88) and severe retinopathy of prematurity (OR, 1.48; 95% CI, 1.02-2.15), whereas there was a lower risk for early-onset sepsis (OR, 0.25; 95% CI, 0.19-0.34), severe intraventricular hemorrhage (OR, 0.65; 95% CI, 0.48-0.88), periventricular leukomalacia (OR, 0.70; 95% CI, 0.48-1.01), and surgical necrotizing enterocolitis or gastrointestinal perforation (OR, 0.47; 95% CI, 0.31-0.72). CONCLUSIONS: Mortality and other adverse outcomes in very preterm infants depend on antecedents of preterm birth. Hypertension and chorioamnionitis are associated with different patterns of outcomes; for mortality, the effect changes across GA weeks.
| Original language | English |
|---|---|
| Journal | Pediatrics |
| Volume | 134 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- Logistic models
- Mortality
- Outcomes
- Pregnancy complications
- Preterm infants
- Risks
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Arts and Humanities (miscellaneous)
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Association of maternal hypertension and chorioamnionitis with preterm outcomes. / Gagliardi, Luigi; Rusconi, Franca; Bellù, Roberto; Zanini, Rinaldo; Mirri, Gianpaolo; Condò, Manuela; Turoli, Daniela; Vanzati, Mara; Mosca, Fabio; De Nisi, Giuseppe; Polacco, Paola; Villa, Elena; Barbarini, Mario; Fasolato, Valeria; Franco, Caterina; Contiero, Raffaella; Ellero, Serena; Cattarossi, Luigi; Abbiati, Laura; Borroni, Cesarina; Prandi, Giovanna; Fabris, Claudio; Vielmi, Francesca; Borgione, Silvia; Agosti, Massimo; Tandoi, Francesco; Guidali, Rosanna; De Curtis, Mario; Tozzi, Claudio; Lucchini, Renato; Battaglioli, Marina; Lista, Gian Luca; Introvini, Paola; Ferrari, Fabrizio; Gallo, Claudio; Bellante, Elvira; Bottura, Chiara; Zeringyte, Aurelija; Pasquali, Francesca; Boccacci, Simona; Latini, Giuseppe; Giannuzzi, Raffaella; Martinelli, Stefano; Brunelli, Alberto; Di Nunzio, Maria Lucia; Vendemmiati, Antonio; Carli, Giovanna; Bordigato, Michela Alfiero; Filippone, Marco; Meneghesso, Davide; Romeo, Nicola; Mammoliti, Palma; Mastretta, Emanuele; Barberis, Laura; Farina, Daniele; Gancia, Gianpaolo; Dalmazzo, Cristina; Napolitano, Marcello; Messina, Francesco; Villa Betania, Napoli; Magaldi, Rosario; Rinaldi, Matteo; Litta, Rosangela; Lago, Paola; Zanardo, Vincenzo; Chiandetti, Lino; Visentin, Stefano; Presta, Giuseppe; Cella, Davide; Poggiani, Carlo; Ferrari, Daniela; Parati, Sara; Lombardo, Francesco; Grigorio, Rosetta; Barera, Graziano; Bove, Maddalena; Poloniato, Antonella; Burgio, Giampiero; Sala, Elena; Barberi, Ignazio; Tiralongo, Venera; Arco, Alessandro; Mazzeo, Danila; Dani, Carlo; Pratesi, Simone; Mignatti, Valeria; Ancora, Gina; Faldella, Giacomo; Grandi, Sara; Locatelli, Chiara; Stronati, Mauro; Perotti, Gianfranco; Chirico, Gaetano; Migliori, Claudio; De Marini, Sergio; Forleo, Vincenzo; Paludetto, Roberto; Capasso, Letizia; Mansi, Giuseppina; Raimondi, Francesco; Bona, Gianni; Stucchi, Ilaria; Savastio, Silvia; Ferrero, Federica; Parola, Andrea; Padovani, Ezio Maria; Viviani, Elena; Pecoraro, Laura; Agostino, Rocco; Gizzi, Camilla; Massenzi, Luca; Messner, Hubert; Staffler, Alex; Salvia, Gennaro; Esposito, Luigi; Forziati, Vincenzo; Latorre, Giuseppe; Sandri, Fabrizio; Alati, Stefania; Demarca, Fabrizio; Lombardi, Oreste; Costabile, Carmine Deni; Scarpelli, Gianfranco; Cavalli, Claudio; Volante, Enrico; Moretti, Sabrina; Ganguzza, Olga; Spinella, Bartolomeo; Haass, Cristina; Scapillati, Eleonora; Consigli, Chiara; Gatta, Alberto; Quitadamo, Pasqua; Boldrini, Antonio; Vuerich, Marco; Sigali, Emilio; Fiorini, Patrizio; Petrucci, Letizia; Moroni, Marco; Meyer, Firenze; Bragetti, Patrizia; Casucci, Paola; Minelli, Liliana; Mezzetti, Daniele; Orfeo, Luigi; De Luca, Maria Gabriella; Laforgia, Nicola; Grassi, Alessandro; Dotta, Andrea; Savignoni, Ferdinando; Bagnoli, Franco; De Felice, Claudio; Badii, Silvia; Biasini, Augusto; Belluzzi, Antonio; Stella, Marcello; Romagnoli, Costantino; Zecca, Enrico; Barone, Giovanni; Colleselli, Paolo; Vecchiato, Luca; Nicolussi, Silvia; Giliberti, Paolo; Chello, Giovanni; Rojo, Silvana; De Vivo, Massimiliano; Giovanettoni, Chiara; Colnaghi, Clelia A.; Manfredini, Valeria; Verucci, Elena; Placidi, Giulia; Belloni, Cesare; Carrera, Giuseppe; Zambetti, Chiara; Biban, Paolo; Serra, Alessandra; Sacco, Francesco; Vetrano, Gennaro; Furcolo, Giuseppe; Pasquariello, Brigida; Falco, Luigi; Ausanio, Gaetano; Bernardo, Italo; Capasso, Antonella; Marchesano, Giuseppe; Nosari, Norberto; Sarnelli, Paola; Ciraci, Giovanni; Merazzi, Daniele; Gazzolo, Diego; Temperini, Francesca; Sabatini, Miriam; Colivicchi, Micaela; Del Vecchio, Antonio; Tarantino, Marzia; Gargano, Giancarlo; Pedori, Simona; Bellettato, Massimo; Pesavento, Roberta; Cesaro, Alessandra; Scollo, Massimo; Mondello, Isabella; Pugliese, Aniello; Iervolino, Claudio; Corsello, Giovanni; Giuffré, Mario; Betta, Pasqua; Romeo, Mario Giuseppe; Saporito, Alessandro; Leone, Maria Grazia; Rodonò, Alessandro; Franceschi, Alessia; Risso, Francesco M.; Carpentieri, Mauro; Vecchiano, Teresa; Cigliano, Maria Pia; Paolillo, Piermichele; Picone, Simonetta; Marra, Antonio; Rossetti, Gessica; Testa, Tiziana; Del Cuore, Fernando; Crescenzi, Francesco; Poloni, Gianna; Russo, Maria Chiara; Nigro, Francesco; Tina, Gabriella Lucia; Brindisino, Patrizia; Gurrado, Raffaele; Felice, Maurizio; Formica, Isabella.
In: Pediatrics, Vol. 134, No. 1, 2014.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association of maternal hypertension and chorioamnionitis with preterm outcomes
AU - Gagliardi, Luigi
AU - Rusconi, Franca
AU - Bellù, Roberto
AU - Zanini, Rinaldo
AU - Mirri, Gianpaolo
AU - Condò, Manuela
AU - Turoli, Daniela
AU - Vanzati, Mara
AU - Mosca, Fabio
AU - De Nisi, Giuseppe
AU - Polacco, Paola
AU - Villa, Elena
AU - Barbarini, Mario
AU - Fasolato, Valeria
AU - Franco, Caterina
AU - Contiero, Raffaella
AU - Ellero, Serena
AU - Cattarossi, Luigi
AU - Abbiati, Laura
AU - Borroni, Cesarina
AU - Prandi, Giovanna
AU - Fabris, Claudio
AU - Vielmi, Francesca
AU - Borgione, Silvia
AU - Agosti, Massimo
AU - Tandoi, Francesco
AU - Guidali, Rosanna
AU - De Curtis, Mario
AU - Tozzi, Claudio
AU - Lucchini, Renato
AU - Battaglioli, Marina
AU - Lista, Gian Luca
AU - Introvini, Paola
AU - Ferrari, Fabrizio
AU - Gallo, Claudio
AU - Bellante, Elvira
AU - Bottura, Chiara
AU - Zeringyte, Aurelija
AU - Pasquali, Francesca
AU - Boccacci, Simona
AU - Latini, Giuseppe
AU - Giannuzzi, Raffaella
AU - Martinelli, Stefano
AU - Brunelli, Alberto
AU - Di Nunzio, Maria Lucia
AU - Vendemmiati, Antonio
AU - Carli, Giovanna
AU - Bordigato, Michela Alfiero
AU - Filippone, Marco
AU - Meneghesso, Davide
AU - Romeo, Nicola
AU - Mammoliti, Palma
AU - Mastretta, Emanuele
AU - Barberis, Laura
AU - Farina, Daniele
AU - Gancia, Gianpaolo
AU - Dalmazzo, Cristina
AU - Napolitano, Marcello
AU - Messina, Francesco
AU - Villa Betania, Napoli
AU - Magaldi, Rosario
AU - Rinaldi, Matteo
AU - Litta, Rosangela
AU - Lago, Paola
AU - Zanardo, Vincenzo
AU - Chiandetti, Lino
AU - Visentin, Stefano
AU - Presta, Giuseppe
AU - Cella, Davide
AU - Poggiani, Carlo
AU - Ferrari, Daniela
AU - Parati, Sara
AU - Lombardo, Francesco
AU - Grigorio, Rosetta
AU - Barera, Graziano
AU - Bove, Maddalena
AU - Poloniato, Antonella
AU - Burgio, Giampiero
AU - Sala, Elena
AU - Barberi, Ignazio
AU - Tiralongo, Venera
AU - Arco, Alessandro
AU - Mazzeo, Danila
AU - Dani, Carlo
AU - Pratesi, Simone
AU - Mignatti, Valeria
AU - Ancora, Gina
AU - Faldella, Giacomo
AU - Grandi, Sara
AU - Locatelli, Chiara
AU - Stronati, Mauro
AU - Perotti, Gianfranco
AU - Chirico, Gaetano
AU - Migliori, Claudio
AU - De Marini, Sergio
AU - Forleo, Vincenzo
AU - Paludetto, Roberto
AU - Capasso, Letizia
AU - Mansi, Giuseppina
AU - Raimondi, Francesco
AU - Bona, Gianni
AU - Stucchi, Ilaria
AU - Savastio, Silvia
AU - Ferrero, Federica
AU - Parola, Andrea
AU - Padovani, Ezio Maria
AU - Viviani, Elena
AU - Pecoraro, Laura
AU - Agostino, Rocco
AU - Gizzi, Camilla
AU - Massenzi, Luca
AU - Messner, Hubert
AU - Staffler, Alex
AU - Salvia, Gennaro
AU - Esposito, Luigi
AU - Forziati, Vincenzo
AU - Latorre, Giuseppe
AU - Sandri, Fabrizio
AU - Alati, Stefania
AU - Demarca, Fabrizio
AU - Lombardi, Oreste
AU - Costabile, Carmine Deni
AU - Scarpelli, Gianfranco
AU - Cavalli, Claudio
AU - Volante, Enrico
AU - Moretti, Sabrina
AU - Ganguzza, Olga
AU - Spinella, Bartolomeo
AU - Haass, Cristina
AU - Scapillati, Eleonora
AU - Consigli, Chiara
AU - Gatta, Alberto
AU - Quitadamo, Pasqua
AU - Boldrini, Antonio
AU - Vuerich, Marco
AU - Sigali, Emilio
AU - Fiorini, Patrizio
AU - Petrucci, Letizia
AU - Moroni, Marco
AU - Meyer, Firenze
AU - Bragetti, Patrizia
AU - Casucci, Paola
AU - Minelli, Liliana
AU - Mezzetti, Daniele
AU - Orfeo, Luigi
AU - De Luca, Maria Gabriella
AU - Laforgia, Nicola
AU - Grassi, Alessandro
AU - Dotta, Andrea
AU - Savignoni, Ferdinando
AU - Bagnoli, Franco
AU - De Felice, Claudio
AU - Badii, Silvia
AU - Biasini, Augusto
AU - Belluzzi, Antonio
AU - Stella, Marcello
AU - Romagnoli, Costantino
AU - Zecca, Enrico
AU - Barone, Giovanni
AU - Colleselli, Paolo
AU - Vecchiato, Luca
AU - Nicolussi, Silvia
AU - Giliberti, Paolo
AU - Chello, Giovanni
AU - Rojo, Silvana
AU - De Vivo, Massimiliano
AU - Giovanettoni, Chiara
AU - Colnaghi, Clelia A.
AU - Manfredini, Valeria
AU - Verucci, Elena
AU - Placidi, Giulia
AU - Belloni, Cesare
AU - Carrera, Giuseppe
AU - Zambetti, Chiara
AU - Biban, Paolo
AU - Serra, Alessandra
AU - Sacco, Francesco
AU - Vetrano, Gennaro
AU - Furcolo, Giuseppe
AU - Pasquariello, Brigida
AU - Falco, Luigi
AU - Ausanio, Gaetano
AU - Bernardo, Italo
AU - Capasso, Antonella
AU - Marchesano, Giuseppe
AU - Nosari, Norberto
AU - Sarnelli, Paola
AU - Ciraci, Giovanni
AU - Merazzi, Daniele
AU - Gazzolo, Diego
AU - Temperini, Francesca
AU - Sabatini, Miriam
AU - Colivicchi, Micaela
AU - Del Vecchio, Antonio
AU - Tarantino, Marzia
AU - Gargano, Giancarlo
AU - Pedori, Simona
AU - Bellettato, Massimo
AU - Pesavento, Roberta
AU - Cesaro, Alessandra
AU - Scollo, Massimo
AU - Mondello, Isabella
AU - Pugliese, Aniello
AU - Iervolino, Claudio
AU - Corsello, Giovanni
AU - Giuffré, Mario
AU - Betta, Pasqua
AU - Romeo, Mario Giuseppe
AU - Saporito, Alessandro
AU - Leone, Maria Grazia
AU - Rodonò, Alessandro
AU - Franceschi, Alessia
AU - Risso, Francesco M.
AU - Carpentieri, Mauro
AU - Vecchiano, Teresa
AU - Cigliano, Maria Pia
AU - Paolillo, Piermichele
AU - Picone, Simonetta
AU - Marra, Antonio
AU - Rossetti, Gessica
AU - Testa, Tiziana
AU - Del Cuore, Fernando
AU - Crescenzi, Francesco
AU - Poloni, Gianna
AU - Russo, Maria Chiara
AU - Nigro, Francesco
AU - Tina, Gabriella Lucia
AU - Brindisino, Patrizia
AU - Gurrado, Raffaele
AU - Felice, Maurizio
AU - Formica, Isabella
PY - 2014
Y1 - 2014
N2 - OBJECTIVES: We compared the relative effect of hypertensive disorders of pregnancy and chorioamnionitis on adverse neonatal outcomes in very preterm neonates, and studied whether gestational age (GA) modulates these effects. METHODS: A cohort of neonates 23 to 30 weeks' GA, born in 2008 to 2011 in 82 hospitals adhering to the Italian Neonatal Network, was analyzed. Infants born from mothers who had hypertensive disorders (N = 2096) were compared with those born after chorioamnionitis (N = 1510). Statistical analysis employed logistic models, adjusting for GA, hospital, and potential confounders. RESULTS: Overall mortality was higher after hypertension than after chorioamnionitis (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.08-1.80), but this relationship changed across GA weeks; the OR for hypertension was highest at low GA, whereas from 28 weeks' GA onward, mortality was higher for chorioamnionitis. For other outcomes, the relative risks were constant across GA; infants born after hypertension had an increased risk for bronchopulmonary dysplasia (OR, 2.20; 95% CI, 1.68-2.88) and severe retinopathy of prematurity (OR, 1.48; 95% CI, 1.02-2.15), whereas there was a lower risk for early-onset sepsis (OR, 0.25; 95% CI, 0.19-0.34), severe intraventricular hemorrhage (OR, 0.65; 95% CI, 0.48-0.88), periventricular leukomalacia (OR, 0.70; 95% CI, 0.48-1.01), and surgical necrotizing enterocolitis or gastrointestinal perforation (OR, 0.47; 95% CI, 0.31-0.72). CONCLUSIONS: Mortality and other adverse outcomes in very preterm infants depend on antecedents of preterm birth. Hypertension and chorioamnionitis are associated with different patterns of outcomes; for mortality, the effect changes across GA weeks.
AB - OBJECTIVES: We compared the relative effect of hypertensive disorders of pregnancy and chorioamnionitis on adverse neonatal outcomes in very preterm neonates, and studied whether gestational age (GA) modulates these effects. METHODS: A cohort of neonates 23 to 30 weeks' GA, born in 2008 to 2011 in 82 hospitals adhering to the Italian Neonatal Network, was analyzed. Infants born from mothers who had hypertensive disorders (N = 2096) were compared with those born after chorioamnionitis (N = 1510). Statistical analysis employed logistic models, adjusting for GA, hospital, and potential confounders. RESULTS: Overall mortality was higher after hypertension than after chorioamnionitis (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.08-1.80), but this relationship changed across GA weeks; the OR for hypertension was highest at low GA, whereas from 28 weeks' GA onward, mortality was higher for chorioamnionitis. For other outcomes, the relative risks were constant across GA; infants born after hypertension had an increased risk for bronchopulmonary dysplasia (OR, 2.20; 95% CI, 1.68-2.88) and severe retinopathy of prematurity (OR, 1.48; 95% CI, 1.02-2.15), whereas there was a lower risk for early-onset sepsis (OR, 0.25; 95% CI, 0.19-0.34), severe intraventricular hemorrhage (OR, 0.65; 95% CI, 0.48-0.88), periventricular leukomalacia (OR, 0.70; 95% CI, 0.48-1.01), and surgical necrotizing enterocolitis or gastrointestinal perforation (OR, 0.47; 95% CI, 0.31-0.72). CONCLUSIONS: Mortality and other adverse outcomes in very preterm infants depend on antecedents of preterm birth. Hypertension and chorioamnionitis are associated with different patterns of outcomes; for mortality, the effect changes across GA weeks.
KW - Logistic models
KW - Mortality
KW - Outcomes
KW - Pregnancy complications
KW - Preterm infants
KW - Risks
UR - http://www.scopus.com/inward/record.url?scp=84902101074&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84902101074&partnerID=8YFLogxK
U2 - 10.1542/peds.2013-3898
DO - 10.1542/peds.2013-3898
M3 - Article
C2 - 24913788
AN - SCOPUS:84902101074
VL - 134
JO - Pediatrics
JF - Pediatrics
SN - 0031-4005
IS - 1
ER -