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Pregnant Women With Placental Infection Have Doubled Risk of Recurrence

emature water breaking, labor induction, use of internal monitors and longer second stages of labor, among other factors, compared with noninfected women. All of these differences were statistically significant, the researchers said. These factors are known to increase the risk of chorioamnionitis at the time of birth because they allow more opportunity for bacteria to migrate from the genital tract to the uterus, Dr. Laibl said.

In the second pregnancies, which were included whether they were vaginal or by Caesarean section, 2,891 deliveries were analyzed. Five percent of women who had had chorioamnionitis in their first pregnancy developed it again, while 2 percent of women who did not have it in their first pregnancy developed it in their second. The difference was statistically significant, even after accounting for those known risk factors for chorioamnionitis, such as length of labor, Dr. Laibl said.

“Circumstances do play an important role,” Dr. Laibl said. “But once you factor that out, the women who got the infection the first time were still more prone to getting it in their second pregnancy.

“The patient’s doctor should be vigilant about infection regardless of her previous pregnancy outcome. That being said, there is no additional treatment to be done for the patient just because she had chorioamnionitis before.”

Research on a cytokine called tumor necrosis factor-alpha, or TNF-alpha, points to a genetic link. Women with one variant of a gene for this cytokine have a threefold risk for chorioamnionitis. Scientists have also found links between other immune-related genes and chorioamnionitis.

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