• Wolfgang Thomas and Christian P Speer.
• Mutterhaus der Borromaeerinnen, Department of Pediatrics, Feldstr. 6, 54290 Trier, Germany. Electronic address: wolfgang.thomas@mutterhaus.de.
• Paediatr Respir Rev. 2014 Mar 1; 15 (1): 49-52.

AbstractBronchopulmonary dysplasia (BPD) is a major sequel of extremely premature birth. Multiple ante- and postnatal factors act in concert to injure the immature lung in the pathogenesis of the disease. Among them, chorioamnionitis--according to current evidence--plays a pivotal role. Pulmonary inflammatory processes seen in animal models of chorioamnionitis resemble those seen in premature infants who developed BPD. Chorioamnionitis can doubtlessly induce extremely preterm birth, thus contributing to a gestation-dependent risk of BPD. A gestation-independent association of chorioamnionitis with an increased risk of developing BPD has been demonstrated by a recent systematic review of clinical observational studies. Antenatal inflammation with signs of a systemic fetal response reduces the response to exogenous surfactant in infants with respiratory distress syndrome, leading to a longer need for mechanical ventilation. Moreover, chorioamnionitis increases the risk of early onset sepsis. Both mechanical ventilation and sepsis are, however, major postnatal risk factors for BPD.Copyright © 2013 Elsevier Ltd. All rights reserved.

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