What is the international prevalence of chorioamnionitis?

Updated: May 08, 2018
  • Author: Fayez M Bany-Mohammed, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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Answer

Developed countries (eg, Canada, Western Europe, Australia) probably have an incidence equal to, or perhaps even less than, the rate of chorioamnionitis observed in the United States. In underdeveloped countries, premature rupture of membranes has a strong association with chorioamnionitis, and chorioamnionitis in this setting results in preterm birth with a high mortality rate. [78] Classic studies by Naeye et al demonstrated that malnourished pregnant women in Africa had a higher risk of ascending urogenital infection with subsequent amniotic fluid infection. [79]  Infection in these malnourished women in Africa was attributed to a decrease in host defense factors in amniotic fluid that regularly prevents disease in this liquor. [80] In developed countries where women receive suboptimal care and have poor nutrition during pregnancy, a higher incidence of infection can be expected because of altered immune defenses. [81]

The bacterial pathogens that cause EOS in developing countries differ from the microbes that cause disease in the United States and other more developed countries, with Klebsiella pneumonia and Pseudomonas aeruginosa being the most common organisms in two reports from India and Pakistan. [82, 83]  For ill-defined reasons, the prevalence of group B streptococcal (GBS) disease is lower in developing countries. It is speculated that as developing countries sustain economic development, the prevalence of different bacterial pathogens assumes a profile closer to that of developed countries.


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