The goal of this study was to evaluate the risk of maternal and neonatal sepsis related with chorioamnionitis. We looked at 1,251 studies. Eligible studies were randomized controlled trials, case-control studies, or cohort studies that quantified a link between chorioamnionitis and sepsis in mothers (postpartum) or neonates delivered at more than 22 weeks of gestation. For meta-analyses, studies were categorized based on histologic or clinical chorioamnionitis exposures and outcomes of maternal or newborn sepsis. One hundred and three papers were included, with 55 meeting meta-analysis criteria. The study’s specifics and quantitative data were extracted. Pooled odds ratios (ORs) were calculated using random-effects models, with most studies reporting only unadjusted data. Histologic chorioamnionitis was linked to newborn sepsis, whether proven or suspected. Clinical chorioamnionitis was also linked to any type of newborn sepsis, whether proven or suspected. Furthermore, both histologic and clinical chorioamnionitis were linked to an increased risk of late-onset sepsis in preterm infants. The incidence of confirmed sepsis in histologic and clinical chorioamnionitis-exposed infants was 7% and 22%, respectively. Three investigations that looked into chorioamnionitis and maternal sepsis came up empty.
Both histologic and clinical chorioamnionitis have been linked to neonatal sepsis, both early and late. Overall, our findings complement existing preventive neonatal care guidelines. The evidence to link chorioamnionitis and maternal sepsis was lacking.
