639: Temporal trends in chorioamnionitis by maternal race/ethnicity and gestational age: 1991-2008
About: This article is published in American Journal of Obstetrics and Gynecology.The article was published on 2011-01-01 and is currently open access. It has received 1 citation(s) till now. The article focuses on the topic(s): Chorioamnionitis & Gestational age.
Summary (1 min read)
- Chorioamnionitis, an infection and inflammation of the maternal and fetal interface, is arguably the most important cause of pretermbirth and infantmorbidity.
- It has been estimated that about 10 percent of all pregnancies are complicated by chorioamnionitis [1, 2].
- Prevalence varies with race/ethnicity and is higher in non-Whites than Whites .
- The most common route of infection is ascending microbial invasion of the amniotic cavity from upper genital tract [13, 14].
- There is a gap in knowledge about the recent trends in chorioamnionitis diagnosis rate and the modifying role of maternal race/ethnicity.
2. Materials and Methods
- The cohort for this study is comprised of all women with a singleton birth at ≥20 weeks gestation who delivered in a KPSC hospital from 1995 to 2010.
- Pregnancies resulting in preterm births or low birthweight were oversampled to ensure adequate number of subjects with chorioamnionitis.
- These findings support the validity of the diagnosis codes in their study.
- The authors decided to exclude women of “other” race/ethnicity from all analyses due to the small number of such women (11,345; 2%).
- Women with chorioamnionitis tend to be younger than those without chorioamnionitis.
- In order to assess the effect of induction of labor on the rate of chorioamnionitis, the authors repeated the analysis after stratifying the data by indication of labor subtypes (indicated, elective, and spontaneous).
- The rate of chorioamnionitis among women with singleton pregnancies delivered in the KPSC hospitals increased by 79% between 1995-1996 and 2009-2010.
- The authors data further showed disparity in rate of chorioamnionitis by maternal race/ethnicity, which is not explained by maternal sociodemographic, behavioral, and perinatal factors.
- In addition to increasing neonatalmorbidity, term chorioamnionitis increases maternal morbidity as well.
- The coding of behavioral risk factors such as smoking during pregnancy may not always be reliable and, additionally, these behaviorsmay be underreported; thus the potential for residual confounding remains.
- Thefindings of this study demonstrated significant variations in the temporal trends of chorioamnionitis by race/ethnicity.
- Chorioamnionitis diagnosis rates increased for women of all race/ethnic groups, both at preterm and term gestation.
- The preponderance of chorioamnionitis at term gestation among Hispanic and Asian/Pacific Islander women appears responsible for the observed disparity in chorioamnionitis.
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Q1. What are the contributions in "Temporal trends in chorioamnionitis by maternal race/ethnicity and gestational age (1995–2010)" ?
In this paper, the authors found significant variations in the temporal trends of chorioamnionitis by race/ethnicity and gestational age at delivery.