%0 Journal Article
%T Temporal Trends in Chorioamnionitis by Maternal Race/Ethnicity and Gestational Age (1995每2010)
%A Michael J. Fassett
%A Deborah A. Wing
%A Darios Getahun
%J International Journal of Reproductive Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/906467
%X Objective. To characterize trends in chorioamnionitis (CAM) by maternal race/ethnicity and gestational age. Study Design. We examined trends in CAM from 1995每2010 among singleton births in all Kaiser Permanente Southern California hospitals ( ). Data were extracted from Perinatal Service System and clinical utilization records. Gestational age- and race/ethnicity-specific biannual diagnosis rates were estimated using the Poisson regression after adjusting for potential confounding factors. Results. Overall diagnosis rates of CAM increased from 2.7% in 1995-1996 to 6.0% in 2009-2010 with a relative increase of 126% (95% confidence intervals [CI] 113%每149%). From 1995-1996 to 2009-2010, CAM increased among the Whites (1.8% to 4.3%, -value for trend <.001), Blacks (2.2% to 3.7%, -value for trend <.001), Hispanics (2.4% to 5.8%, -value for trend <.001), and Asian/Pacific Islanders (3.6% to 9.0%, -value for trend <.001). The adjusted relative percentage change in CAM from 1995-1996 to 2009-2010 was for Whites [preterm 21% (9%每78%), term 138% (108%每173%)], for Blacks [preterm 24% (ˋ9%每81%), term 62% (30%每101%)], for Hispanics [preterm 31% (3%每66%), term 135% (114%每159%)], and for Asian/Pacific Islanders [preterm 44% (9%每127%), term 145% (109%每188%)]. Conclusion. The findings suggest that CAM diagnosis rate has increased for all race/ethnic groups. This increase is primarily due to increased diagnosis at term gestation. 1. Introduction Chorioamnionitis, an infection and inflammation of the maternal and fetal interface, is arguably the most important cause of preterm birth and infant morbidity. Despite advancements in diagnosis and treatment, chorioamnionitis and its complications remain major public health concern in the United States. It has been estimated that about 10 percent of all pregnancies are complicated by chorioamnionitis [1, 2]. Documented immediate and long-term sequelae of chorioamnionitis include fetal mortality [3], preterm premature rupture of membranes [4], neonatal intensive care admission [5], bronchopulmonary dysplasia [6, 7], and cerebral palsy [8]. Most importantly, chorioamnionitis is responsible for approximately half of all preterm births [9每11]. Prevalence varies with race/ethnicity and is higher in non-Whites than Whites [12]. The most common route of infection is ascending microbial invasion of the amniotic cavity from upper genital tract [13, 14]. Inflammatory processes at sites remote from the female genital tracts are also described as important sources of infection [15, 16]. There is a gap in knowledge about the recent trends
%U http://www.hindawi.com/journals/ijrmed/2013/906467/