Association Between Preterm Brain Injury and Exposure to Chorioamnionitis During Fetal Life

Overview

Journal Sci Rep

Specialty Science

Date 2016 Dec 2

PMID 27905410

Citations 50

Authors

Devasuda Anblagan

Rozalia Pataky

Margaret J Evans

Emma J Telford

Ahmed Serag

Sarah Sparrow

Chinthika Piyasena

Scott I Semple

Alastair Graham Wilkinson

Mark E Bastin

James P Boardman

Affiliations

Soon will be listed here.

Abstract

Preterm infants are susceptible to inflammation-induced white matter injury but the exposures that lead to this are uncertain. Histologic chorioamnionitis (HCA) reflects intrauterine inflammation, can trigger a fetal inflammatory response, and is closely associated with premature birth. In a cohort of 90 preterm infants with detailed placental histology and neonatal brain magnetic resonance imaging (MRI) data at term equivalent age, we used Tract-based Spatial Statistics (TBSS) to perform voxel-wise statistical comparison of fractional anisotropy (FA) data and computational morphometry analysis to compute the volumes of whole brain, tissue compartments and cerebrospinal fluid, to test the hypothesis that HCA is an independent antenatal risk factor for preterm brain injury. Twenty-six (29%) infants had HCA and this was associated with decreased FA in the genu, cingulum cingulate gyri, centrum semiovale, inferior longitudinal fasciculi, limbs of the internal capsule, external capsule and cerebellum (p < 0.05, corrected), independent of degree of prematurity, bronchopulmonary dysplasia and postnatal sepsis. This suggests that diffuse white matter injury begins in utero for a significant proportion of preterm infants, which focuses attention on the development of methods for detecting fetuses and placentas at risk as a means of reducing preterm brain injury.

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