Chorioamnionitis is a bacterial infection that occurs either during or before the labor and is linked to preterm birth and neonatal infection. However, the association between chorioamnionitis and outcomes among preterm neonates is not clear. This study aims to evaluate the neonatal and neurodevelopmental outcomes in infants with exposure to chorioamnionitis.

This longitudinal observational study included a total of 2,390 extremely preterm infants (gestational age [GA] less than 27 weeks). The eligible participants had variable exposure to chorioamnionitis: no chorioamnionitis, histological chorioamnionitis alone, or histological plus clinical chorioamnionitis. The primary endpoints of the study were cognitive, behavioral, and neurodevelopmental outcomes, including behavioral scores, cerebral palsy, gross motor functional limitation, and composite measures of death/neurodevelopmental impairment.

The findings suggested that neonates exposed to chorioamnionitis had a lower GA and increased rates of severe periventricular-intraventricular hemorrhage and early-onset sepsis, as compared with neonates with no exposure to chorioamnionitis. Histological plus clinical chorioamnionitis was linked with a greater risk of cognitive impairment (odds ratio 2.38), as compared with infants with no exposure. Histological chorioamnionitis alone was not associated with a higher risk of death or neurodevelopmental impairment.

The research concluded that antenatal exposure to chorioamnionitis was associated with an increased risk of cognitive impairment, death, and neurodevelopmental impairment in extremely preterm infants.