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  • Title: Chorioamnionitis, mechanical ventilation, and postnatal sepsis as modulators of chronic lung disease in preterm infants.
    Author: Van Marter LJ, Dammann O, Allred EN, Leviton A, Pagano M, Moore M, Martin C, Developmental Epidemiology Network Investigators.
    Journal: J Pediatr; 2002 Feb; 140(2):171-6. PubMed ID: 11865267.
    Abstract:
    OBJECTIVE: This case-control study of chronic lung disease (CLD) evaluated the hypothesis that chorioamnionitis promotes CLD and interacts with other risk factors for CLD, including mechanical ventilation and postnatal infection. STUDY DESIGN: We identified a population of 193 infants who met our case criteria for CLD whose birth weights were <or=1500 g. These infants were matched 1:1 with control infants for gestational age and hospital of birth. RESULTS: Univariable analyses revealed decreased CLD risk associated with histologic chorioamnionitis and increased risk associated with mechanical ventilation >7 days and culture-documented sepsis. In multivariable analyses, infants were at greatest risk for CLD when they had exposure to both chorioamnionitis and either mechanical ventilation >7 days (odds ratio, 3.2; 95% confidence interval, 0.9-11) or postnatal infection (odds ratio, 2.9; 95% confidence interval, 1.1-7.4). CONCLUSIONS: We conclude that prolonged mechanical ventilation or postnatal infection increases the risk of CLD among surviving preterm infants and that these 2 factors interact with antenatal infection to further increase the risk of CLD.
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