Chorioamnionitis and Neonatal Morbidity in Extremely Preterm Infants Born at 23–28 Weeks: A Single-Centre Retrospective Study

Background: /Objectives: Chorioamnionitis, an inflammation, with or without infection, involving the amniotic fluid, placenta, fetal membranes or decidua, can significantly impact fetal and neonatal development. This study aimed to determine the incidence of chorioamnionitis and confirm its correlation with neonatal morbidity and mortality, in a single tertiary center. Materials and Methods: This observational, retrospective study was conducted over three years (2019-2021) in a tertiary neonatal intensive care unit, examining 80 preterm infants born at 23-28 weeks of gestation. Pearson correlation and χ² tests were used to assess associations between chorioamnionitis exposure and neonatal outcomes. Results: Among the 80 newborns analysed, clinical chorioamnionitis was identified in 12 preterm infants, while 46 presented histological chorioamnionitis. A weak but significant negative correlation (r = –0.27, p = 0.0152) between gestational age and chorioamnionitis stage indicated that preterm infants born at lower gestational ages are more frequently exposed to this intrauterine infection. Histological chorioamnionitis stage was significantly associated with early onset sepsis (r=0.31, p=0.0048), severity of respiratory distress syndrome (r=0.25, p=0.0242), bronchopulmonary dysplasia (r=0.26, p=0.0212), and retinopathy of prematurity (r=0.26, p=0.0249). Conclusion: Histological chorioamnionitis was significantly associated with early onset sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, and retinopathy of prematurity. No significant association was found between chorioamnionitis and neonatal mortality. While clinical diagnostic criteria for chorioamnionitis demonstrated good specificity, their poor sensitivity underscores the urgent need for improved diagnostic tools.