Cerebral blood flow velocity in asymptomatic premature neonates exposed to clinical chorioamnionitis

AimsTo test the hypothesis that cerebral blood flow velocity (CBFV) is altered in asymptomatic premature neonates exposed to clinical chorioamnionitis.MethodsThis prospective observational study included 30 premature (<34 weeks) neonates who were exposed to clinical chorioamnionitis but did not develop any feature of early-onset neonatal sepsis. Thirty gestational-age matched healthy neonates served as controls. Cord blood interleukin (IL)-6 concentrations were measured at birth. Resistance index (RI), pulsatility index (PI), peak systolic flow velocity and vascular diameter of internal carotid, vertebral and middle cerebral arteries were measured by transcranial color doppler ultrasonography within 48 h of delivery. The infants were followed up clinically after discharge and magnetic resonance imaging (MRI) was done at the corrected age of 6 months.ResultsConventional sepsis screen and blood culture was negative in all. Significantly higher cord blood IL-6 concentrations, lower resistance (RI and PI) and higher blood flow with vasodilation were recorded in all cerebral arteries of the chorioamnionitis group. Significant correlation was observed between the increase in CBFV and the increase of IL-6 concentrations. At the age of 6 months, two cases showed features of delayed developmental milestone and periventricular leucomalacia in MRI.ConclusionsAsymptomatic premature neonates exposed to clinical chorioamnionitis had significantly increased cord blood IL-6 concentrations and CBFV. The utility of increased CBFV as a predictor of adverse neurodevelopmental outcome may be tested in a well designed longitudinal study with larger sample size.