Chorioamnionitis as a risk factor for retinopathy of prematurity: An updated systematic review and meta-analysis

Eduardo Villamor-Martinez*, Giacomo Cavallaro, Genny Raffaeli, Owais M. M. Mohammed Rahim, Silvia Gulden, Amro M. T. Ghazi, Fabio Mosca, Pieter Degraeuwe

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

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, = 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.

Original languageEnglish
Article number0205838
Number of pages20
JournalPLOS ONE
Volume13
Issue number10
DOIs
Publication statusPublished - 17 Oct 2018

Keywords

  • LOW-BIRTH-WEIGHT
  • LOW-GESTATIONAL-AGE
  • MATERNAL CLINICAL CHORIOAMNIONITIS
  • PRETERM INFANTS
  • HISTOLOGICAL CHORIOAMNIONITIS
  • BRONCHOPULMONARY DYSPLASIA
  • PREGNANCY DISORDERS
  • NEONATAL MORBIDITY
  • PLACENTAL INFLAMMATION
  • MANAGEMENT

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