Influence of intraamniotic infection/ inflammation on fetal cortical development

To assess the influence of intra-amniotic infection and/or inflammation (IAI) on fetal cortical development. Prospective cohort study (2018-2021) conducted in Hospital Clinic and Hospital Sant Joan de Déu (BCNatal, Barcelona) including singleton pregnancies. The exposed group included women with preterm labor (PTL) and/or preterm prelabor rupture of membranes (PPROM) with IAI (positive amniotic fluid culture and/or high levels of IL6) (group A) and without IAI (group B). The non-exposed group included women without PTL/PPROM (group C). Cortical development was assessed by neurosonography by measuring depth (mm) of the Sylvian fissure, parieto-occipital, cingulate and calcarine sulci within the first 72h after admission and, in non-exposed women, at a similar gestational age. Measures were normalized by biparietal diameter (BPD) and analysis was adjusted for EFW up to 10th centile and fetal sex. For the overall population, 41 had IAI (28/41 were PPROM), 54 had symptoms of PTL/PPROM without IAI (6/54 were PPROM), and 48 were non-exposed women (without symptoms of PTL/PPROM). There were no significant differences in maternal characteristics (including maternal age, BMI, ethnicity, smoking habit, prevalence of hypertension, pregestational diabetes or artificial reproduction techniques and parity), fetal sex, head circumference, or gestational age at ultrasound between groups. There were more fetuses with estimated fetal weight under 10th centile in the IAI group. The exposed groups showed reduced Sylvian fissures depth compared to non-exposed women. There were no other differences in the parieto-occipital, cingulate and calcarine sulci depth. Fetuses with PTL or PPROM had reduced Sylvian fissures when compared with controls, suggesting changes in prenatal brain development of fetuses at risk of preterm delivery.