Erratum: Outcomes of Very-Low-Birth-Weight Infants Exposed to Maternal Clinical Chorioamnionitis: A Multicentre Study

<b><i>Background:</i></b> Chorioamnionitis is a recognized risk factor of preterm delivery; however, controversy still persists concerning the relationship between maternal inflammation and neonatal morbidity and mortality. <b><i>Objective:</i></b> To determine the incidence of clinical chorioamnionitis and its relationship to morbidity and mortality among very-low-birth-weight (VLBW) infants. <b><i>Methods:</i></b> This was a retrospective analysis of prospectively collected data of VLBW neonates ≤32 weeks' gestational age (GA) admitted to collaborating units in the Spanish SEN1500 Network between January 2008 and December 2011. Clinical chorioamnionitis was defined by obstetricians based on clinical findings, and neonatal outcomes were compared between exposed and non-exposed infants by multivariate logistic regression analysis. <b><i>Results:</i></b> During the study period, 11,464 VLBW newborns were admitted to our units and 10,026 were ≤32 weeks' GA. Among them, 8,330 (83.1%) had complete data and were included. Of these, 1,480 (17.8%) were exposed to maternal clinical chorioamnionitis. The incidence was higher at lower GA and, after adjusting for confounding factors, exposed infants had higher risks of early-onset neonatal sepsis (EONS) (10.0 vs. 2.8%; aOR 3.102; 95% CI 2.306-4.173; p &lt; 0.001) and necrotizing enterocolitis (NEC) (11.2 vs. 7.7%; aOR 1.300; 95% CI 1.021-1.655; p &lt; 0.033), but lower risks of patent ductus arteriosus (PDA) (43.2 vs. 34.9%; aOR 0.831; 95% CI 0.711-0.971; p &lt; 0.02) and late-onset bacterial sepsis (LONS) (36.6 vs. 32.5%; aOR 0.849; 95% CI 0.729-0.989; p &lt; 0.035). There were no differences in mortality between the groups. <b><i>Conclusions:</i></b> The incidence of maternal clinical chorioamnionitis is inversely related to GA at delivery, and in VLBW infants ≤32 weeks' GA it is associated with higher risks of EONS and NEC, but lower risks of PDA and LONS. We did not found differences in survival.

**<i>背景：</i>** 绒毛膜羊膜炎(Chorioamnionitis)是公认的早产危险因素，但母体炎症与新生儿发病率及死亡率之间的关联仍存在争议。
**<i>目的：</i>** 明确临床型绒毛膜羊膜炎的发病率，及其与极低出生体重儿(very-low-birth-weight, VLBW)的发病率和死亡率之间的关联。
**<i>方法：</i>** 本研究为回顾性分析，研究对象为2008年1月至2011年12月期间，纳入西班牙SEN1500协作网络各协作中心的胎龄(gestational age, GA)≤32周的极低出生体重新生儿的前瞻性收集数据。临床型绒毛膜羊膜炎由产科医师基于临床体征判定，采用多因素logistic回归分析对比暴露组与非暴露组新生儿的预后结局。
**<i>结果：</i>** 研究期间，本协作中心共收治11464例极低出生体重新生儿，其中10026例胎龄≤32周。最终纳入8330例（占比83.1%）资料完整的受试者，其中1480例（17.8%）存在母体临床型绒毛膜羊膜炎暴露史。发病率随胎龄降低而升高；校正混杂因素后，暴露组新生儿早发型新生儿败血症(early-onset neonatal sepsis, EONS)发病风险显著升高（10.0% vs 2.8%；调整后比值比(aOR) 3.102；95%置信区间(95% CI) 2.306~4.173；P<0.001），坏死性小肠结肠炎(necrotizing enterocolitis, NEC)发病风险亦升高（11.2% vs 7.7%；aOR 1.300；95% CI 1.021~1.655；P<0.033）；但动脉导管未闭(patent ductus arteriosus, PDA)（43.2% vs 34.9%；aOR 0.831；95% CI 0.711~0.971；P<0.02）及晚发型细菌性败血症(late-onset bacterial sepsis, LONS)（36.6% vs 32.5%；aOR 0.849；95% CI 0.729~0.989；P<0.035）的发病风险显著降低。两组新生儿死亡率无显著差异。
**<i>结论：</i>** 母体临床型绒毛膜羊膜炎的发病率与分娩时胎龄呈负相关；对于胎龄≤32周的极低出生体重儿而言，该暴露与早发型新生儿败血症、坏死性小肠结肠炎发病风险升高相关，而与动脉导管未闭、晚发型细菌性败血症发病风险降低相关。本研究未观察到两组新生儿生存率存在显著差异。