ACC's work on the current manuscript was in part supported by National Heart, Lung, and Blood Institute reentry award RO1HL081663. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: This study was funded by the Maternal Child Health Bureau, Health Resources and Services Administration (R40 MC00248). Received: JAccepted: JanuPublished: March 7, 2012Ĭopyright: © 2012 Roberts et al. (2012) Acute Histologic Chorioamnionitis at Term: Nearly Always Noninfectious. Histologic chorioamnionitis was also associated with elevated serum levels of interleukin-8 (median = 1.3 pg/mL no histologic chorioamnionitis, 1.5 pg/mL Grade 1, 2.1 pg/mL Grade 2, P = 0.05) and interleukin-6 (median levels = 2.2 pg/mL no chorioamnionitis, 5.3 pg/mL Grade 1, 24.5 pg/mL Grade 2, P = 0.02) at admission for delivery as well as higher admission WBC counts (mean = 12,000cells/mm 3 no chorioamnionitis, 13,400cells/mm 3 Grade 1, 15,700cells/mm 3 Grade 2, P = 0.0005).Ĭitation: Roberts DJ, Celi AC, Riley LE, Onderdonk AB, Boyd TK, Johnson LC, et al. The association remained significant in a logistic regression controlling for potential confounders (OR = 5.8, 95% CI = 2.2,15.0). Most febrile women had received epidural for pain relief, though the association with fever was present with and without epidural. Histologic chorioamnionitis was strongly associated with intrapartum fever >38☌. Grade 1 or grade 2 histologic chorioamnionitis was present in 34% of placentas (67/195), but infection was present in only 4% (8/195). Placental membranes were scored and categorized as: no chorioamnionitis, Grade 1 (subchorionitis and patchy acute chorioamnionitis), or Grade 2 (severe, confluent chorioamnionitis).
Infection was defined as ≥1,000 cfu of a single known pathogen or a ≥2 log difference in counts for a known pathogen versus other organisms in a mixed culture. Histologic and microbiologic evaluation of placentas included anaerobic and aerobic cultures (including mycoplasma/ureaplasma species) as well as PCR. We conducted a secondary analysis among 195 low-risk women with term pregnancies enrolled in a randomized trial.
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