Introduction. Chorioamnionitis, an intra-amniotic infection associated with preterm delivery, has been linked to adverse pulmonary outcomes in neonates, including respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD).
The objective of the study was to evaluate the incidence and severity of pulmonary complications in preterm infants with confirmed chorioamnionitis.
Materials and methods. This prospective cohort study included preterm neonates admitted to the Neonatal Intensive Care Unit (NICU) of the Public Healthcare Institution – Mother and Child Institute, Chisinau, Republic of Moldova, between October 2023 and July 2024, following ethics committee approval. Eligible participants were grouped based on the presence of histologically or clinically confirmed chorioamnionitis. Clinical data, including the incidence of respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), and other pulmonary complications, as well as respiratory support requirements (mechanical ventilation, continuous positive airway pressure), were extracted from medical records. Statistical analysis included chi-square tests and logistic regression, adjusting for confounders such as birth weight and gestational age.
Results. Of the 108 infants, 54 infants were exposed to chorioamnionitis, and 54 infants served as controls. The incidence of BPD was significantly higher in the chorioamnionitis group (25.9% vs. 3.7%, p<0.05), and RDS was prevalent in both groups (100% vs. 98.1%). We also detected complications such as pneumonia, pulmonary hemorrhage, pulmonary hypertension, atelectasis, and pneumothorax, but without a significant association with chorioamnionitis.
Conclusion. Chorioamnionitis significantly increases the risk of severe RDS and BPD in preterm neonates born before 34 weeks of gestation, contributing to a prolonged need for mechanical ventilation. These findings emphasize the importance of early identification and targeted management in high-risk populations. Further research on interventions to mitigate the pulmonary impact of chorioamnionitis is warranted to improve outcomes for this vulnerable group.
Keywords: preterm neonates, chorioamnionitis, pulmonary complications, respiratory distress syndrome, bronchopulmonary dysplasia.
Full text sources https://doi.org/10.31688/ABMU.2025.60.1.12
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Address for correspondence:
Liuba DASCALIUC
Department of Pediatrics, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Public Healthcare Institution – Mother and Child Institute, Chisinau, Republic of Moldova
Email: liuba.dascaliuc@usmf.md; Phone: +373 60575901
