Perinatal inflammation/infection and its association with correction of metabolic acidosis in hypoxic-ischemic encephalopathy

Journal of Perinatology : Official Journal of the California Perinatal Association
C T JohnsonErnest M Graham

Abstract

To investigate the decreased response to hypothermia in neonates with hypoxic-ischemic encephalopathy (HIE) and infection, we sought to determine the association of fetal inflammation/infection with perinatal metabolic acidosis. We performed a retrospective cohort study of neonates with suspected HIE started on whole-body hypothermia within 6 h of birth that had a cord gas at delivery and placental pathology performed. Neonates were compared based on the presence of clinical and histologic chorioamnionitis. The cord gas at delivery was compared with the initial arterial gas after birth. In all, 50 out of 67 (74.6%) neonates admitted for therapeutic hypothermia met inclusion criteria. Chorioamnionitis did not affect the cord gas at delivery, but both clinical and histologic chorioamnionitis were associated with a significantly increased metabolic acidosis on the initial neonatal arterial gas. Chorioamnionitis, diagnosed both clinically and histologically, is associated with a persistent state of acidosis in neonates with HIE that may contribute to worse neurologic outcomes.

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Citations

Nov 9, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Cally J TannUNKNOWN GBS Neonatal Encephalopathy Investigator Group
May 7, 2019·Frontiers in Pediatrics·Saima AslamEleanor J Molloy
Aug 15, 2018·Nature Reviews. Neurology·Steven J KorzeniewskiNigel Paneth
Oct 15, 2020·Acta Obstetricia Et Gynecologica Scandinavica·Tullio GhiTiziana Frusca
Nov 14, 2020·Current Pharmaceutical Design·Ferenc Domoki

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