Sensitivity of histological chorioaminionitis and premature rupture of membranes for neonatal sepsis and its risk factors

Objectives

Set the sensitivity of the histopathological diagnosis of chorioamnionitis (CAMH) for early diagnosis of neonatal sepsis and the relationship between histological chorioamnionitis and premature rupture of membranes and neonatal sepsis.

Materials and methods

Prospective, observational study and diagnostic test performed in the Neonatology Service of the “Dr. José Eleuterio González” University Hospital. Epidemiological variables were collected from mothers and newborns. The relationship between histological chorioamnionitis with premature rupture of membranes and early neonatal sepsis was established.

Results

We recorded 3694 births. Of these, 122 patients were studied as potentially infected, of whom 37 patients were excluded (2 by transfer to another hospital and 35 by not finding a histopathological study of the placenta). The study included 85 newborns. Of these, 43 (50.5%) developed clinical and laboratory data of early neonatal sepsis, the rest (n = 42, 49.5%) were healthy newborns. The sensitivity of histological chorioamnionitis with premature rupture of membranes (PRM) of more than 24 h was 81% for neonatal sepsis and 51% without. The risk factors for neonatal sepsis were: Mother with infection (p < 0.001), weight <1500 g (<0.001), gestational age <28 weeks (<0.05), APGAR score <6 in 5 min (p < 0.05).

Conclusions

Placental chorioamnionitis with premature rupture of membranes > 24 h has an 81% sensitivity for neonatal sepsis. A newborn with histological chorioamnionitis has a 51% sensitivity for neonatal sepsis.