Effect of chorioamnionitis on necrotizing enterocolitis in preterm infants: a multicenter cohort study
BackgroundTo explore the association between maternal chorioamnionitis (CAM) exposure and necrotising enterocolitis (NEC) in very preterm infants (VPI) or very low birth weight (VLBWI).MethodsThe aim of this multicentre cohort study was to investigate the impact of maternal CAM and its different sta...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1620101/full |
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| author | Xin Guo Jiaming Xian Xianhong Chen Xianhong Chen Meifen Li Fengji Lin Defei Ma Rongrong Zhang Guichao Zhong Huiying Tu Shujuan Zeng Houxin Kang Ya Pan Xiaoli Li Xueli Zhang Zhangxing Wang Hanni Lin Shihua Yuan Jing Han |
| author_facet | Xin Guo Jiaming Xian Xianhong Chen Xianhong Chen Meifen Li Fengji Lin Defei Ma Rongrong Zhang Guichao Zhong Huiying Tu Shujuan Zeng Houxin Kang Ya Pan Xiaoli Li Xueli Zhang Zhangxing Wang Hanni Lin Shihua Yuan Jing Han |
| author_sort | Xin Guo |
| collection | DOAJ |
| description | BackgroundTo explore the association between maternal chorioamnionitis (CAM) exposure and necrotising enterocolitis (NEC) in very preterm infants (VPI) or very low birth weight (VLBWI).MethodsThe aim of this multicentre cohort study was to investigate the impact of maternal CAM and its different staging on VPI or VLBWI NEC in six medical centres in Shenzhen between 2022 and 2023. The primary outcome was NEC (Bell staging ≥ II) and secondary outcomes included NEC or in-hospital mortality. Logistic regression adjusted for confounders identified through directed acyclic graphs (DAG) and literature review. The interaction effect of premature rupture of membranes was assessed using stratification and likelihood ratio tests.ResultsIn the cohort study, the prevalence of CAM was 44.31%, the prevalence of NEC was 5.38%, and the prevalence of NEC or death was 7.69%. Of the 288 participants whose mothers had been exposed to CAM, 1.04% had clinical CAM, 96.53% had histological CAM, and 2.43% were diagnosed with confirmed CAM. CAM was associated with NEC or death (aOR = 1.90, 95% CI 1.02–3.55); the confirmed CAM group showed a stronger association (aOR = 7.14, 95% CI 1.20–42.35). In preterm infants, CAM was significantly associated with NEC or death in cases of preterm membrane rupture (aOR = 2.18, 95% CI 1.07–4.44).ConclusionsThere was a significant positive association between CAM and NEC or death in VLBWs or VPIs, which was mainly from the population with confirmed CAM. In premature rupture of membranes, the association between CAM and NEC or death was more significant. |
| format | Article |
| id | doaj-art-262add397f6d4912b82abe6a42e08b0c |
| institution | DOAJ |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-262add397f6d4912b82abe6a42e08b0c2025-08-20T03:16:08ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-07-011310.3389/fped.2025.16201011620101Effect of chorioamnionitis on necrotizing enterocolitis in preterm infants: a multicenter cohort studyXin Guo0Jiaming Xian1Xianhong Chen2Xianhong Chen3Meifen Li4Fengji Lin5Defei Ma6Rongrong Zhang7Guichao Zhong8Huiying Tu9Shujuan Zeng10Houxin Kang11Ya Pan12Xiaoli Li13Xueli Zhang14Zhangxing Wang15Hanni Lin16Shihua Yuan17Jing Han18Department of Neonatology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, ChinaDepartment of Neonatology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, ChinaShenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guang-dong, ChinaDivision of Neonatology, Longgang Central Hospital of Shenzhen, Shenzhen, Guangdong, ChinaDepartment of Pediatrics, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, ChinaDepartment of Neonatology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, ChinaDepartment of Neonatology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, ChinaDepartment of Neonatology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, ChinaDepartment of Neonatology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, ChinaDepartment of Neonatology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, ChinaDivision of Neonatology, Longgang Central Hospital of Shenzhen, Shenzhen, Guangdong, ChinaNeonatal·Child Critical Child Health Care Division, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Tujia and Miao Autonomous Prefecture, Hubei, ChinaNeonatal Department, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, ChinaNeonatal Department, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, ChinaDivision of Neonatology, Shenzhen Longhua People’s Hospital, Shenzhen, Guangdong, ChinaDivision of Neonatology, Shenzhen Longhua People’s Hospital, Shenzhen, Guangdong, ChinaDepartment of Neonatology, Shenzhen Luohu People’s Hospital, Shenzhen, Guangdong, ChinaDepartment of Neonatology, Shenzhen Luohu People’s Hospital, Shenzhen, Guangdong, ChinaDepartment of Neonatology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, ChinaBackgroundTo explore the association between maternal chorioamnionitis (CAM) exposure and necrotising enterocolitis (NEC) in very preterm infants (VPI) or very low birth weight (VLBWI).MethodsThe aim of this multicentre cohort study was to investigate the impact of maternal CAM and its different staging on VPI or VLBWI NEC in six medical centres in Shenzhen between 2022 and 2023. The primary outcome was NEC (Bell staging ≥ II) and secondary outcomes included NEC or in-hospital mortality. Logistic regression adjusted for confounders identified through directed acyclic graphs (DAG) and literature review. The interaction effect of premature rupture of membranes was assessed using stratification and likelihood ratio tests.ResultsIn the cohort study, the prevalence of CAM was 44.31%, the prevalence of NEC was 5.38%, and the prevalence of NEC or death was 7.69%. Of the 288 participants whose mothers had been exposed to CAM, 1.04% had clinical CAM, 96.53% had histological CAM, and 2.43% were diagnosed with confirmed CAM. CAM was associated with NEC or death (aOR = 1.90, 95% CI 1.02–3.55); the confirmed CAM group showed a stronger association (aOR = 7.14, 95% CI 1.20–42.35). In preterm infants, CAM was significantly associated with NEC or death in cases of preterm membrane rupture (aOR = 2.18, 95% CI 1.07–4.44).ConclusionsThere was a significant positive association between CAM and NEC or death in VLBWs or VPIs, which was mainly from the population with confirmed CAM. In premature rupture of membranes, the association between CAM and NEC or death was more significant.https://www.frontiersin.org/articles/10.3389/fped.2025.1620101/fullnecrotizing enterocolitisvery low birth weight infantschorioamnionitisvery preterm infantsdeath |
| spellingShingle | Xin Guo Jiaming Xian Xianhong Chen Xianhong Chen Meifen Li Fengji Lin Defei Ma Rongrong Zhang Guichao Zhong Huiying Tu Shujuan Zeng Houxin Kang Ya Pan Xiaoli Li Xueli Zhang Zhangxing Wang Hanni Lin Shihua Yuan Jing Han Effect of chorioamnionitis on necrotizing enterocolitis in preterm infants: a multicenter cohort study Frontiers in Pediatrics necrotizing enterocolitis very low birth weight infants chorioamnionitis very preterm infants death |
| title | Effect of chorioamnionitis on necrotizing enterocolitis in preterm infants: a multicenter cohort study |
| title_full | Effect of chorioamnionitis on necrotizing enterocolitis in preterm infants: a multicenter cohort study |
| title_fullStr | Effect of chorioamnionitis on necrotizing enterocolitis in preterm infants: a multicenter cohort study |
| title_full_unstemmed | Effect of chorioamnionitis on necrotizing enterocolitis in preterm infants: a multicenter cohort study |
| title_short | Effect of chorioamnionitis on necrotizing enterocolitis in preterm infants: a multicenter cohort study |
| title_sort | effect of chorioamnionitis on necrotizing enterocolitis in preterm infants a multicenter cohort study |
| topic | necrotizing enterocolitis very low birth weight infants chorioamnionitis very preterm infants death |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1620101/full |
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