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Chorioamnionitis and Subsequent Lung Function in Preterm Infants.doc

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Chorioamnionitis and Subsequent Lung Function in Preterm Infants

ChorioamnionitisandSubsequentLungFunctionin PretermInfants MarcusH.Jones1*.,Andre′aL.Corso1.,RobertS.Tepper2,MariaI.A.Edelweiss3,LucianaFriedrich4, PauloM.C.Pitrez1,RenatoT.Stein1 1InstituteofBiomedicalResearch,andSchoolofMedicine,Pontif?′ciaUniversidadeCato′licadoRioGrandedoSul,PortoAlegre,Brazil,2DepartmentofPediatrics,James WhitcombRileyHospitalforChildren,HermanB.WellsCenterforPediatricResearch,IndianaUniversity,Indianapolis,Indiana,UnitedStatesofAmerica,3Departmentof Pathology,SchoolofMedicineandHospitaldeCl?′nicasdePortoAlegre,UniversidadeFederaldoRioGrandedoSul,Brazil,4NeonatologySection,HospitaldeCl?′nicasde PortoAlegre,Brazil Abstract Objective:Toexploretherelationshipbetweenprematurity,genderandchorioamnionitisasdeterminantsofearlylifelung functioninprematureinfants. Methods:Placentaandmembraneswerecollectedfrompretermdeliveries(,37weeksgestationalage)andevaluatedfor histological chorioamnionitis (HCA). Patients were followed and lung function was performed in the first year of life by RaisedVolume-RapidThoracicCompressionTechnique. Results: Ninety-five infants (43 males) born prematurely (median gestational age 34.2 weeks) were recruited. HCA was detectedin66(69%)oftheplacentas,andofthese55(58%)werescoredHCAGrade1,and11(12%)HCAGrade2.Infants exposedtoHCAGrade1andGrade2,whencomparedtothosenotexposed,presentedsignificantlylowergestationalages, higher prevalence of RDS, clinical early-onset sepsis, and the use of supplemental oxygen more than 28 days. Infants exposed to HCA also had significantly lower maximal flows. There was a significant negative trend for z-scores of lung functioninrelationtolevelsofHCA;infantshadlowermaximalexpiratoryflowswithincreasinglevelofHCA.(p=0.012for FEF50,p=0.014forFEF25–75 andp=0.32forFEV0.5).Two-wayANOVAadjustedforlengthandgestationalageindicateda significantinteraction between sexandHCAin determiningexpiratory flows(p,0.01forFEF50,FEF25–75 andp,0.05 for FEV0.5).Post-hoccomparisonsrevealedthatfemalepreterminfantsexpos