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Open Access 01-04-2024 | Paracetamol | REVIEW

The influence of chorioamnionitis on respiratory drive and spontaneous breathing of premature infants at birth: a narrative review

Authors: Timothy J. R. Panneflek, Kristel L. A. M. Kuypers, Graeme R. Polglase, Douglas P. Derleth, Janneke Dekker, Stuart B. Hooper, Thomas van den Akker, Arjan B.te Pas

Published in: European Journal of Pediatrics | Issue 6/2024

Abstract

Most very premature infants breathe at birth but require respiratory support in order to stimulate and support their breathing. A significant proportion of premature infants are affected by chorioamnionitis, defined as an umbrella term for antenatal inflammation of the foetal membranes and umbilical vessels. Chorioamnionitis produces inflammatory mediators that potentially depress the respiratory drive generated in the brainstem. Such respiratory depression could maintain itself by delaying lung aeration, hampering respiratory support at birth and putting infants at risk of hypoxic injury. This inflammatory-mediated respiratory depression may contribute to an association between chorioamnionitis and increased requirement of neonatal resuscitation in premature infants at birth. This narrative review summarises mechanisms on how respiratory drive and spontaneous breathing could be influenced by chorioamnionitis and provides possible interventions to stimulate spontaneous breathing.

Conclusion: Chorioamnionitis could possibly depress respiratory drive and spontaneous breathing in premature infants at birth. Interventions to stimulate spontaneous breathing could therefore be valuable.

What is Known: • A large proportion of premature infants are affected by chorioamnionitis, antenatal inflammation of the foetal membranes and umbilical vessels.
What is New: • Premature infants affected by chorioamnionitis might be exposed to higher concentrations of respiratory drive inhibitors which could depress breathing at birth. • Premature infants affected by chorioamnionitis seem to be associated with a higher and more extensive requirement of resuscitation at birth.

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These criteria consist of fever and one of the following symptoms: leukocytosis, purulent vaginal discharge or foetal tachycardia.

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Title: The influence of chorioamnionitis on respiratory drive and spontaneous breathing of premature infants at birth: a narrative review
Authors: Timothy J. R. Panneflek
Kristel L. A. M. Kuypers
Graeme R. Polglase
Douglas P. Derleth
Janneke Dekker
Stuart B. Hooper
Thomas van den Akker
Arjan B.te Pas
Publication date: 01-04-2024
Publisher: Springer Berlin Heidelberg
Keyword: Paracetamol
Published in: European Journal of Pediatrics / Issue 6/2024
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-024-05508-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The influence of chorioamnionitis on respiratory drive and spontaneous breathing of premature infants at birth: a narrative review

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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