Chorioamnionitis as a risk factor for retinopathy of prematurity: An updated systematic review and meta-analysis
The role of chorioamnionitis (CA) in the development of retinopathy of prematurity (ROP) is difficult to establish, because CA-exposed and CA-unexposed infants frequently present different baseline characteristics. We performed an updated systematic review and meta-analysis of studies reporting on t...
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| Veröffentlicht in: | PloS one 2018-10, Vol.13 (10), p.e0205838-e0205838 |
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| creator | Villamor-Martinez, Eduardo Cavallaro, Giacomo Raffaeli, Genny Mohammed Rahim, Owais M M Gulden, Silvia Ghazi, Amro M T Mosca, Fabio Degraeuwe, Pieter Villamor, Eduardo |
| description | The role of chorioamnionitis (CA) in the development of retinopathy of prematurity (ROP) is difficult to establish, because CA-exposed and CA-unexposed infants frequently present different baseline characteristics. We performed an updated systematic review and meta-analysis of studies reporting on the association between CA and ROP. We searched PubMed and EMBASE for relevant articles. Studies were included if they examined preterm or very low birth weight (VLBW, |
| doi_str_mv | 10.1371/journal.pone.0205838 |
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We performed an updated systematic review and meta-analysis of studies reporting on the association between CA and ROP. We searched PubMed and EMBASE for relevant articles. Studies were included if they examined preterm or very low birth weight (VLBW, <1500g) infants and reported primary data that could be used to measure the association between exposure to CA and the presence of ROP. Of 748 potentially relevant studies, 50 studies met the inclusion criteria (38,986 infants, 9,258 CA cases). Meta-analysis showed a significant positive association between CA and any stage ROP (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.11 to 1.74). CA was also associated with severe (stage ≥3) ROP (OR 1.63, 95% CI 1.41 to 1.89). Exposure to funisitis was associated with a higher risk of ROP than exposure to CA in the absence of funisitis. Additional meta-analyses showed that infants exposed to CA had lower gestational age (GA) and lower birth weight (BW). Meta-regression showed that lower GA and BW in the CA-exposed group was significantly associated with a higher risk of ROP. Meta-analyses of studies with data adjusted for confounders could not find a significant association between CA and ROP. In conclusion, our study confirms that CA is a risk factor for developing ROP. However, part of the effects of CA on the pathogenesis of ROP may be mediated by the role of CA as an etiological factor for very preterm birth.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0205838</identifier><identifier>PMID: 30332485</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Babies ; Biology and Life Sciences ; Birth weight ; Case-Control Studies ; Chorioamnionitis ; Chorioamnionitis - diagnosis ; Cohort Studies ; Complications and side effects ; Confidence intervals ; Development and progression ; Developmental biology ; Etiology ; Exposure ; Female ; Gestational Age ; Health risks ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Infants ; Infections ; Inflammation ; Intensive care ; Low birth weight ; Medicine and Health Sciences ; Meta-analysis ; Newborn babies ; Odds Ratio ; Oncology ; Oxygen therapy ; Pathogenesis ; Pediatrics ; Physical Sciences ; Pregnancy ; Premature Birth ; Quality Assurance, Health Care ; Regression Analysis ; Research and Analysis Methods ; Retinopathy ; Retinopathy of prematurity ; Retinopathy of Prematurity - complications ; Retinopathy of Prematurity - diagnosis ; Risk analysis ; Risk Factors ; Statistical analysis ; Studies ; Systematic review ; Upgrading ; Weight</subject><ispartof>PloS one, 2018-10, Vol.13 (10), p.e0205838-e0205838</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Villamor-Martinez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Villamor-Martinez et al 2018 Villamor-Martinez et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-136a637a9019791f671794fbb1366e21012542244430d9dd309c6aa09ab141a73</citedby><cites>FETCH-LOGICAL-c692t-136a637a9019791f671794fbb1366e21012542244430d9dd309c6aa09ab141a73</cites><orcidid>0000-0001-5280-7832 ; 0000-0002-4921-1437 ; 0000-0001-9175-9394</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192636/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192636/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53770,53772,79347,79348</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30332485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Baud, Olivier</contributor><creatorcontrib>Villamor-Martinez, Eduardo</creatorcontrib><creatorcontrib>Cavallaro, Giacomo</creatorcontrib><creatorcontrib>Raffaeli, Genny</creatorcontrib><creatorcontrib>Mohammed Rahim, Owais M M</creatorcontrib><creatorcontrib>Gulden, Silvia</creatorcontrib><creatorcontrib>Ghazi, Amro M T</creatorcontrib><creatorcontrib>Mosca, Fabio</creatorcontrib><creatorcontrib>Degraeuwe, Pieter</creatorcontrib><creatorcontrib>Villamor, Eduardo</creatorcontrib><title>Chorioamnionitis as a risk factor for retinopathy of prematurity: An updated systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The role of chorioamnionitis (CA) in the development of retinopathy of prematurity (ROP) is difficult to establish, because CA-exposed and CA-unexposed infants frequently present different baseline characteristics. We performed an updated systematic review and meta-analysis of studies reporting on the association between CA and ROP. We searched PubMed and EMBASE for relevant articles. Studies were included if they examined preterm or very low birth weight (VLBW, <1500g) infants and reported primary data that could be used to measure the association between exposure to CA and the presence of ROP. Of 748 potentially relevant studies, 50 studies met the inclusion criteria (38,986 infants, 9,258 CA cases). Meta-analysis showed a significant positive association between CA and any stage ROP (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.11 to 1.74). CA was also associated with severe (stage ≥3) ROP (OR 1.63, 95% CI 1.41 to 1.89). Exposure to funisitis was associated with a higher risk of ROP than exposure to CA in the absence of funisitis. Additional meta-analyses showed that infants exposed to CA had lower gestational age (GA) and lower birth weight (BW). Meta-regression showed that lower GA and BW in the CA-exposed group was significantly associated with a higher risk of ROP. Meta-analyses of studies with data adjusted for confounders could not find a significant association between CA and ROP. In conclusion, our study confirms that CA is a risk factor for developing ROP. However, part of the effects of CA on the pathogenesis of ROP may be mediated by the role of CA as an etiological factor for very preterm birth.</description><subject>Babies</subject><subject>Biology and Life Sciences</subject><subject>Birth weight</subject><subject>Case-Control Studies</subject><subject>Chorioamnionitis</subject><subject>Chorioamnionitis - diagnosis</subject><subject>Cohort Studies</subject><subject>Complications and side effects</subject><subject>Confidence intervals</subject><subject>Development and progression</subject><subject>Developmental biology</subject><subject>Etiology</subject><subject>Exposure</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Health risks</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Very Low Birth Weight</subject><subject>Infants</subject><subject>Infections</subject><subject>Inflammation</subject><subject>Intensive care</subject><subject>Low birth weight</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Newborn babies</subject><subject>Odds Ratio</subject><subject>Oncology</subject><subject>Oxygen therapy</subject><subject>Pathogenesis</subject><subject>Pediatrics</subject><subject>Physical Sciences</subject><subject>Pregnancy</subject><subject>Premature Birth</subject><subject>Quality Assurance, Health Care</subject><subject>Regression Analysis</subject><subject>Research and Analysis Methods</subject><subject>Retinopathy</subject><subject>Retinopathy of prematurity</subject><subject>Retinopathy of Prematurity - complications</subject><subject>Retinopathy of Prematurity - diagnosis</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Systematic review</subject><subject>Upgrading</subject><subject>Weight</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12L1DAUhoso7jr6D0QDgujFjPlq2nghDIMfAwsLft2G0zadydg23SRdnX9vZqe7TGUvpC0tOc_7Juf0nCR5TvCCsIy829nBddAsetvpBaY4zVn-IDknktG5oJg9PPk-S554v8M4ZbkQj5MzhhmjPE_Pk361tc5YaDtjOxOMRxBv5Iz_hWoog3Wojo_TwXS2h7DdI1uj3ukWwuBM2L9Hyw4NfQVBV8jvfThETBkV10b_RtBVqNUB5hDPuvfGP00e1dB4_Wx8z5Ifnz5-X32ZX1x-Xq-WF_NSSBrmhAkQLAOJicwkqUVGMsnroogBoSnBhKacUs45w5WsKoZlKQCwhIJwAhmbJS-Pvn1jvRqL5RUllPAsetJIrI9EZWGnemdacHtlwaibBes2ClxMpdEKE8aKrMIV5bFsRZnnJSkwCIylTmnGoteHcbehaHVV6i44aCam00hntmpjr5UgkgomosGb0cDZq0H7oFrjS9000Gk73JybppJxnkf01T_o_dmN1AZiAqarbdy3PJiqZZpKQTIR22GWLO6h4lXp1pSxs2oT1yeCtxNBZIL-EzYweK_W377-P3v5c8q-PmG3Gpqw9bYZQmxLPwX5ESyd9d7p-q7IBKvDYNxWQx0GQ42DEWUvTn_Qneh2Ethf3sgHYA</recordid><startdate>20181017</startdate><enddate>20181017</enddate><creator>Villamor-Martinez, Eduardo</creator><creator>Cavallaro, Giacomo</creator><creator>Raffaeli, Genny</creator><creator>Mohammed Rahim, Owais M M</creator><creator>Gulden, Silvia</creator><creator>Ghazi, Amro M T</creator><creator>Mosca, Fabio</creator><creator>Degraeuwe, Pieter</creator><creator>Villamor, Eduardo</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-5280-7832</orcidid><orcidid>https://orcid.org/0000-0002-4921-1437</orcidid><orcidid>https://orcid.org/0000-0001-9175-9394</orcidid></search><sort><creationdate>20181017</creationdate><title>Chorioamnionitis as a risk factor for retinopathy of prematurity: An updated systematic review and meta-analysis</title><author>Villamor-Martinez, Eduardo ; Cavallaro, Giacomo ; Raffaeli, Genny ; Mohammed Rahim, Owais M M ; Gulden, Silvia ; Ghazi, Amro M T ; Mosca, Fabio ; Degraeuwe, Pieter ; Villamor, Eduardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-136a637a9019791f671794fbb1366e21012542244430d9dd309c6aa09ab141a73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Babies</topic><topic>Biology and Life Sciences</topic><topic>Birth weight</topic><topic>Case-Control Studies</topic><topic>Chorioamnionitis</topic><topic>Chorioamnionitis - diagnosis</topic><topic>Cohort Studies</topic><topic>Complications and side effects</topic><topic>Confidence intervals</topic><topic>Development and progression</topic><topic>Developmental biology</topic><topic>Etiology</topic><topic>Exposure</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Health risks</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Very Low Birth Weight</topic><topic>Infants</topic><topic>Infections</topic><topic>Inflammation</topic><topic>Intensive care</topic><topic>Low birth weight</topic><topic>Medicine and Health Sciences</topic><topic>Meta-analysis</topic><topic>Newborn babies</topic><topic>Odds Ratio</topic><topic>Oncology</topic><topic>Oxygen therapy</topic><topic>Pathogenesis</topic><topic>Pediatrics</topic><topic>Physical Sciences</topic><topic>Pregnancy</topic><topic>Premature Birth</topic><topic>Quality Assurance, Health Care</topic><topic>Regression Analysis</topic><topic>Research and Analysis Methods</topic><topic>Retinopathy</topic><topic>Retinopathy of prematurity</topic><topic>Retinopathy of Prematurity - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Villamor-Martinez, Eduardo</au><au>Cavallaro, Giacomo</au><au>Raffaeli, Genny</au><au>Mohammed Rahim, Owais M M</au><au>Gulden, Silvia</au><au>Ghazi, Amro M T</au><au>Mosca, Fabio</au><au>Degraeuwe, Pieter</au><au>Villamor, Eduardo</au><au>Baud, Olivier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chorioamnionitis as a risk factor for retinopathy of prematurity: An updated systematic review and meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-10-17</date><risdate>2018</risdate><volume>13</volume><issue>10</issue><spage>e0205838</spage><epage>e0205838</epage><pages>e0205838-e0205838</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The role of chorioamnionitis (CA) in the development of retinopathy of prematurity (ROP) is difficult to establish, because CA-exposed and CA-unexposed infants frequently present different baseline characteristics. We performed an updated systematic review and meta-analysis of studies reporting on the association between CA and ROP. We searched PubMed and EMBASE for relevant articles. Studies were included if they examined preterm or very low birth weight (VLBW, <1500g) infants and reported primary data that could be used to measure the association between exposure to CA and the presence of ROP. Of 748 potentially relevant studies, 50 studies met the inclusion criteria (38,986 infants, 9,258 CA cases). Meta-analysis showed a significant positive association between CA and any stage ROP (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.11 to 1.74). CA was also associated with severe (stage ≥3) ROP (OR 1.63, 95% CI 1.41 to 1.89). Exposure to funisitis was associated with a higher risk of ROP than exposure to CA in the absence of funisitis. Additional meta-analyses showed that infants exposed to CA had lower gestational age (GA) and lower birth weight (BW). Meta-regression showed that lower GA and BW in the CA-exposed group was significantly associated with a higher risk of ROP. Meta-analyses of studies with data adjusted for confounders could not find a significant association between CA and ROP. In conclusion, our study confirms that CA is a risk factor for developing ROP. However, part of the effects of CA on the pathogenesis of ROP may be mediated by the role of CA as an etiological factor for very preterm birth.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30332485</pmid><doi>10.1371/journal.pone.0205838</doi><tpages>e0205838</tpages><orcidid>https://orcid.org/0000-0001-5280-7832</orcidid><orcidid>https://orcid.org/0000-0002-4921-1437</orcidid><orcidid>https://orcid.org/0000-0001-9175-9394</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_2121471972 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Babies Biology and Life Sciences Birth weight Case-Control Studies Chorioamnionitis Chorioamnionitis - diagnosis Cohort Studies Complications and side effects Confidence intervals Development and progression Developmental biology Etiology Exposure Female Gestational Age Health risks Humans Infant, Newborn Infant, Premature Infant, Very Low Birth Weight Infants Infections Inflammation Intensive care Low birth weight Medicine and Health Sciences Meta-analysis Newborn babies Odds Ratio Oncology Oxygen therapy Pathogenesis Pediatrics Physical Sciences Pregnancy Premature Birth Quality Assurance, Health Care Regression Analysis Research and Analysis Methods Retinopathy Retinopathy of prematurity Retinopathy of Prematurity - complications Retinopathy of Prematurity - diagnosis Risk analysis Risk Factors Statistical analysis Studies Systematic review Upgrading Weight |
| title | Chorioamnionitis as a risk factor for retinopathy of prematurity: An updated systematic review and meta-analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T06%3A23%3A37IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Chorioamnionitis%20as%20a%20risk%20factor%20for%20retinopathy%20of%20prematurity:%20An%20updated%20systematic%20review%20and%20meta-analysis&rft.jtitle=PloS%20one&rft.au=Villamor-Martinez,%20Eduardo&rft.date=2018-10-17&rft.volume=13&rft.issue=10&rft.spage=e0205838&rft.epage=e0205838&rft.pages=e0205838-e0205838&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0205838&rft_dat=%3Cgale_plos_%3EA559617605%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2121471972&rft_id=info:pmid/30332485&rft_galeid=A559617605&rft_doaj_id=oai_doaj_org_article_0133b7d0d24248bc88c1b0a6009e5273&rfr_iscdi=true |