Table II.
Pregnancy and neonatal outcome according to the presence or absence of intra-amniotic inflammation
| Intra-amniotic inflammation | P value | |||
|---|---|---|---|---|
|
|
||||
| Negativea (n=116) |
Positiveb (n=16) |
Unadjusted | Adjusted c | |
| Gestational age at delivery (wk)d | 38.4 (21.4-42.6) | 32.7 (21.4-38.3) | <.001 | – |
| Amniocentesis-to-delivery interval (n) | ||||
| ≤48 hr | 7 (6.0%) | 5 (31.3%) | < .01 | < .01 |
| ≤7 d | 15 (12.9%) | 12 (75.0%) | < .001 | < .001 |
| Preterm delivery (n) | 38 (32.8%) | 14 (87.5%) | <.001 | < .001 |
| Clinical chorioamnionitis (n) | 0 (0.0%) | 3 (18.8%) | < .01 | – |
| Histologic chorioamnionitis (n/N)e,f | 15/66 (22.7%) | 7/10 (70.0%) | < .01 | < .01 |
| Funisitis (n/N)e,f | 2/66 (3.0%) | 5/10 (50.0%) | < .001 | < .001 |
| Birthweight (g)d | 2930 (390-4200) | 1865 (550-2810) | < .001 | – |
| 1-minute Apgar score <4 (n/N) f | 7/92 (7.6%) | 4/14 (28.6%) | < .05 | .054 |
| 5-minute Apgar score <7 (n/N) f | 5/92 (5.4%) | 4/14 (28.6%) | < .05 | < .05 |
| Neonatal deaths (n/N) g | 2/112 (1.8%) | 4/16 (25.0%) | < .01 | < .01 |
| Shortly after birth,<1 day | 1 | 4 | ||
| Perinatal period,<1 month | 1 | 0 | ||
| Admission to NICU (n/N)f,h | 18/92 (19.6%) | 7/11 (63.6%) | < .01 | < .01 |
| Significant neonatal morbidity (n/N)f,h | 9/92 (9.8%) | 3/11 (27.3%) | NS | NS |
| Neonatal mortality and significant morbidity (n/N) |
10/93 (10.8%) | 7/15 (46.7%) | < .01 | < .01 |
AF, amniotic fluid; MMP-8, matrix metalloproteinase-8; NS, not significant; NICU, neonatal intensive care unit.
Negative, AF MMP-8 < 23 ng/mL.
Positive, AF MMP-8 > 23 ng/mL.
Adjusted for gestational age at amniocentesis (logistic regression analysis).
Values are given as median (range).
Cases without placental examination were excluded.
Cases delivered at other hospitals were excluded, most of them were delivered at term without complication.
Cases with major anomaly were excluded.
Cases with major anomaly or died in the delivery room were excluded. Significant neonatal morbidity was defined as the presence of any following conditions: proven neonatal sepsis, respiratory distress syndrome, pneumonia, bronchopulmonary dysplasia, intraventricular hemorrhage (grade ≥ II), and necrotizing enterocolitis. Five newborns who died within 1 day with or without resuscitation due to extreme prematurity were excluded because they could not be evaluated for morbidity.