Background Early infant CRP levels in the setting of Chorioamnionitis (CA) have not been fully defined as a predictor of cognitive, behavioural, and neuro-developmental outcomes among extremely preterm neonates.

Methods 499 preterm neonates had Placental pathology, CRP level and Vermont Oxford outcomes recorded. Death and developmental outcomes at 2 yrs were examined for 247 preterm infants <32 wks and <1.5 kg. Multivariable logistic and linear regression models were developed to assess the association between CA and outcomes controlling for gestational age.

Results 499 preterm infants were included with mean birth weight of 1074 +/- 273 g and gestational age of 28.5 +/-2.7 weeks. Infants with CA (N = 127) had lower GA and birth weight and higher rates of early onset sepsis. The Fetal inflammatory response was associated with: Apgar <7 at 10 mins; intubation in the delivery room; PDA; RDS; pneumothorax and oxygen on Day 28.

Infants with Day 1 CRP >10 mg/L needed significantly more resuscitation in the Delivery room (DR) including adrenaline and cardiac compressions. They were significantly more at risk of RDS, ROP, grade III/IV IVH.

Conclusion There is a correlation between both initial CRP and histological CA with adverse short term outcomes.