BIOCHEMICAL AND PHYSIOLOGICAL CHANGES IN MOTHERS WITH CHORIOAMNIONITIS AND THEIR IMPACT ON NEONATAL OUTCOMES

Abstract

Background: Chorioamnionitis is a condition in which the fetal membranes and amniotic cavity become inflamed, which can cause significant changes to happen in the mother and to the baby. Identifying biochemical and physiological abnormalities in the mother early in pregnancy could be used to identify babies who are at greater risk of poor outcome.
Objective: To evaluate biochemical and physiological changes in mothers with chorioamnionitis and determine their impact on neonatal outcomes.
Methodology: This prospective observational study took place in Kabir Medical College, Peshawar from January 2025 to June 2025. 82 pregnant women with clinical chorioamnionitis (0.26% of all deliveries) were enrolled using the consecutive non-probability sampling method. Physiological parameters of the mother were recorded such as temperature, heart rate, respiratory rate, blood pressure and fetal heart rate. Laboratory tests performed were complete blood count, neutrophil-to-lymphocyte ratio, C-reactive protein, procalcitonin and serum lactate. The neonatal outcomes were Apgar score, early-onset sepsis, respiratory distress, NICU admission, requirement for respiratory support, stillbirth, and early neonatal death. The appropriate statistical tests were used to assess associations and multivariable logistic regression was used to determine independent predictors of adverse neonatal outcomes.
Results: Maternal fever was present in 82.9% of participants, maternal tachycardia in 73.2%, leukocytosis in 67.1%, raised C-reactive protein in 78.0%, elevated procalcitonin in 46.3%, and serum lactate above 2 mmol/L in 25.6%. NICU admission occurred in 52.4% of neonates, early-onset sepsis in 32.9%, respiratory distress in 30.5%, and perinatal mortality in 9.8%. Prolonged rupture of membranes, fetal tachycardia, raised maternal procalcitonin, elevated lactate, and lower gestational age were independently associated with adverse neonatal outcomes.
Conclusion: Maternal chorioamnionitis was associated with substantial inflammatory and physiological disturbances and a high frequency of neonatal complications. Combined clinical and biochemical assessment may support early risk stratification and timely maternal and neonatal management.