Association of maternal hypertension and chorioamnionitis with preterm outcomes

Luigi Gagliardi, Franca Rusconi, Roberto Bellù, Rinaldo Zanini, Gianpaolo Mirri, Manuela Condò, Daniela Turoli, Mara Vanzati, Fabio Mosca, Giuseppe De Nisi, Paola Polacco, Elena Villa, Mario Barbarini, Valeria Fasolato, Caterina Franco, Raffaella Contiero, Serena Ellero, Luigi Cattarossi, Laura Abbiati, Cesarina BorroniGiovanna Prandi, Claudio Fabris, Francesca Vielmi, Silvia Borgione, Massimo Agosti, Francesco Tandoi, Rosanna Guidali, Mario De Curtis, Claudio Tozzi, Renato Lucchini, Marina Battaglioli, Gian Luca Lista, Paola Introvini, Fabrizio Ferrari, Claudio Gallo, Elvira Bellante, Chiara Bottura, Aurelija Zeringyte, Francesca Pasquali, Simona Boccacci, Giuseppe Latini, Raffaella Giannuzzi, Stefano Martinelli, Alberto Brunelli, Maria Lucia Di Nunzio, Antonio Vendemmiati, Giovanna Carli, Michela Alfiero Bordigato, Marco Filippone, Davide Meneghesso, Nicola Romeo, Palma Mammoliti, Emanuele Mastretta, Laura Barberis, Daniele Farina, Gianpaolo Gancia, Cristina Dalmazzo, Marcello Napolitano, Francesco Messina, Napoli Villa Betania, Rosario Magaldi, Matteo Rinaldi, Rosangela Litta, Paola Lago, Vincenzo Zanardo, Lino Chiandetti, Stefano Visentin, Giuseppe Presta, Davide Cella, Carlo Poggiani, Daniela Ferrari, Sara Parati, Francesco Lombardo, Rosetta Grigorio, Graziano Barera, Maddalena Bove, Antonella Poloniato, Giampiero Burgio, Elena Sala, Ignazio Barberi, Venera Tiralongo, Alessandro Arco, Danila Mazzeo, Carlo Dani, Simone Pratesi, Valeria Mignatti, Gina Ancora, Giacomo Faldella, Sara Grandi, Chiara Locatelli, Mauro Stronati, Gianfranco Perotti, Gaetano Chirico, Claudio Migliori, Sergio De Marini, Vincenzo Forleo, Roberto Paludetto, Letizia Capasso, Giuseppina Mansi, Francesco Raimondi, Gianni Bona, Ilaria Stucchi, Silvia Savastio, Federica Ferrero, Andrea Parola, Ezio Maria Padovani, Elena Viviani, Laura Pecoraro, Rocco Agostino, Camilla Gizzi, Luca Massenzi, Hubert Messner, Alex Staffler, Gennaro Salvia, Luigi Esposito, Vincenzo Forziati, Giuseppe Latorre, Fabrizio Sandri, Stefania Alati, Fabrizio Demarca, Oreste Lombardi, Carmine Deni Costabile, Gianfranco Scarpelli, Claudio Cavalli, Enrico Volante, Sabrina Moretti, Olga Ganguzza, Bartolomeo Spinella, Cristina Haass, Eleonora Scapillati, Chiara Consigli, Alberto Gatta, Pasqua Quitadamo, Antonio Boldrini, Marco Vuerich, Emilio Sigali, Patrizio Fiorini, Letizia Petrucci, Marco Moroni, Firenze Meyer, Patrizia Bragetti, Paola Casucci, Liliana Minelli, Daniele Mezzetti, Luigi Orfeo, Maria Gabriella De Luca, Nicola Laforgia, Alessandro Grassi, Andrea Dotta, Ferdinando Savignoni, Franco Bagnoli, Claudio De Felice, Silvia Badii, Augusto Biasini, Antonio Belluzzi, Marcello Stella, Costantino Romagnoli, Enrico Zecca, Giovanni Barone, Paolo Colleselli, Luca Vecchiato, Silvia Nicolussi, Paolo Giliberti, Giovanni Chello, Silvana Rojo, Massimiliano De Vivo, Chiara Giovanettoni, Clelia A. Colnaghi, Valeria Manfredini, Elena Verucci, Giulia Placidi, Cesare Belloni, Giuseppe Carrera, Chiara Zambetti, Paolo Biban, Alessandra Serra, Francesco Sacco, Gennaro Vetrano, Giuseppe Furcolo, Brigida Pasquariello, Luigi Falco, Gaetano Ausanio, Italo Bernardo, Antonella Capasso, Giuseppe Marchesano, Norberto Nosari, Paola Sarnelli, Giovanni Ciraci, Daniele Merazzi, Diego Gazzolo, Francesca Temperini, Miriam Sabatini, Micaela Colivicchi, Antonio Del Vecchio, Marzia Tarantino, Giancarlo Gargano, Simona Pedori, Massimo Bellettato, Roberta Pesavento, Alessandra Cesaro, Massimo Scollo, Isabella Mondello, Aniello Pugliese, Claudio Iervolino, Giovanni Corsello, Mario Giuffré, Pasqua Betta, Mario Giuseppe Romeo, Alessandro Saporito, Maria Grazia Leone, Alessandro Rodonò, Alessia Franceschi, Francesco M. Risso, Mauro Carpentieri, Teresa Vecchiano, Maria Pia Cigliano, Piermichele Paolillo, Simonetta Picone, Antonio Marra, Gessica Rossetti, Tiziana Testa, Fernando Del Cuore, Francesco Crescenzi, Gianna Poloni, Maria Chiara Russo, Francesco Nigro, Gabriella Lucia Tina, Patrizia Brindisino, Raffaele Gurrado, Maurizio Felice, Isabella Formica

Research output: Contribution to journalArticle

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 languageEnglish
JournalPediatrics
Volume134
Issue number1
DOIs
Publication statusPublished - 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)

Cite this

Gagliardi, L., Rusconi, F., Bellù, R., Zanini, R., Mirri, G., Condò, M., Turoli, D., Vanzati, M., Mosca, F., De Nisi, G., Polacco, P., Villa, E., Barbarini, M., Fasolato, V., Franco, C., Contiero, R., Ellero, S., Cattarossi, L., Abbiati, L., ... Formica, I. (2014). Association of maternal hypertension and chorioamnionitis with preterm outcomes. Pediatrics, 134(1). https://doi.org/10.1542/peds.2013-3898