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

AbstractThe 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. 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.

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A Systematic Review and Meta-Analysis of Human Milk Feeding and Short-Term Growth in Preterm and Very Low Birth Weight Infants

Nutrients ◽

10.3390/nu13062089 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2089

Author(s):

Machiko Suganuma ◽

Alice R. Rumbold ◽

Jacqueline Miller ◽

Yan Fong Chong ◽

Carmel T. Collins

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Very Low Birth Weight ◽

Meta Analysis ◽

Poor Quality ◽

Low Birth Weight Infants ◽

Preterm Formula ◽

Meta Analyses

Human milk (HM) is the gold standard for feeding infants but has been associated with slower growth in preterm infants compared with preterm formula. This systematic review and meta-analysis summarises the post-1990 literature to examine the effect of HM feeding on growth during the neonatal admission of preterm infants with birth weight ≤1500 g and/or born ≤28 weeks’ gestation. Medline, PubMed, CINAHL, and Scopus were searched, and comparisons were grouped as exclusive human milk (EHM) vs. exclusive preterm formula (EPTF), any HM vs. EPTF, and higher vs. lower doses of HM. We selected studies that used fortified HM and compared that with a PTF; studies comparing unfortified HM and term formula were excluded. Experimental and observational studies were pooled separately. The GRADE system was used to evaluate risk of bias and certainty of evidence. Forty-four studies were included with 37 (n = 9963 infants) included in the meta-analyses. In general, due to poor quality studies, evidence of the effect of any HM feeds or higher versus lower doses of HM was inconclusive. There was a possible effect that lower doses of HM compared with higher doses of HM improved weight gain during the hospital admission, and separately, a possible effect of increased head circumference growth in infants fed EPTF vs. any HM. The clinical significance of this is unclear. There was insufficient evidence to determine the effects of an exclusive HM diet on any outcomes.

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Chorioamnionitis as a Risk Factor for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Neonatology ◽

10.1159/000357556 ◽

2014 ◽

Vol 105 (3) ◽

pp. 189-199 ◽

Cited By ~ 30

Author(s):

Souvik Mitra ◽

Dagfinn Aune ◽

Christian P. Speer ◽

Ola Didrik Saugstad

Keyword(s):

Systematic Review ◽

Risk Factor ◽

Retinopathy Of Prematurity ◽

Meta Analysis

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Is Donated Breast Milk Better Than Formula for Feeding Very Low Birth Weight Infants? A Systematic Review and Meta‐Analysis

Worldviews on Evidence-Based Nursing ◽

10.1111/wvn.12410 ◽

2019 ◽

Vol 16 (6) ◽

pp. 485-494 ◽

Cited By ~ 1

Author(s):

Fei Yu ◽

Bo Cao ◽

Zunjia Wen ◽

Meng Li ◽

Hongbin Chen ◽

...

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Breast Milk ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Meta Analysis ◽

Low Birth Weight Infants ◽

Better Than

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Systematic review of the role of gender as a health determinant of hospitalization for depression

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646230400090x ◽

2004 ◽

Vol 20 (2) ◽

pp. 115-127 ◽

Cited By ~ 10

Author(s):

Isabelle Savoie ◽

Denise Morettin ◽

Carolyn J. Green ◽

Arminée Kazanjian

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Bipolar Disorders ◽

Primary Data ◽

Health Determinants ◽

Adult Women ◽

Health Determinant ◽

Hospitalization Rates ◽

Reported Data

Objectives:To conduct a systematic review of selected health determinants, including gender, and their impact on hospitalization rates for depression. Depression includes both depressive and bipolar disorders. Selected health determinants were gender, age, sex, family structure, education, and socioeconomic status.Methods:Systematic search of conventional and fugitive literature sources. All reports of primary data, systematic reviews, and meta-analysis of primary data were included if they focused on hospitalization for depression and reported data by one or more of the selected health determinants. Two researchers independently evaluated each citation for inclusion and extracted data from the included studies.Results:There is an important underreporting of health determinants data in studies of hospitalization for depression. No studies examined the role of gender. Age and sex were reported in 83 percent and 80 percent of the 110 included studies. Women showed a higher rate of hospitalization for depression than men (p<.05). Age and diagnosis had different effects in men and women. Adult women were significantly more likely than men to report a depressive disorder, whereas men were more likely to report a bipolar disorder (p<.05). Little can be concluded on the other health determinants.Conclusions:The importance of reporting hospitalization data and conducting hospital utilization analysis by sex and health determinants, including gender, must be emphasized.

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Association between sepsis and retinopathy of prematurity: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-025440 ◽

2019 ◽

Vol 9 (5) ◽

pp. e025440 ◽

Cited By ~ 3

Author(s):

Xiaofen Wang ◽

Kun Tang ◽

Ling Chen ◽

Sixiang Cheng ◽

Huilan Xu

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Premature Infants ◽

Retinopathy Of Prematurity ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Library ◽

Case Control Studies ◽

Severe Stage

ObjectiveTo explore the association between sepsis and retinopathy of prematurity (ROP) in premature infants.DesignA systematic review and meta-analysis.Data sourcesWe performed a systematic search of PubMed, the Cochrane Library and Embase from 1 January, 2000, to 1 January, 2018, with no language restrictions and reported the relationship between sepsis and ROP.Eligibility criteriaOriginal observational studies, including cohort studies and case-control studies.Data extraction and synthesisTwo reviewers independently completed the study selection and data extraction. The OR and corresponding 95% CI were used to measure the risk of sepsis in patients with ROP. The heterogeneity between studies was evaluated using Cochran’s Q test and the I2statistic. The Newcastle-Ottawa Scale was adopted to evaluate the quality of each of the included studies, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the quality of the evidence.ResultsSixteen studies with a total sample size of 12 466 premature infants and 2494 cases of ROP were included in this meta-analysis. Adjusted analysis showed that sepsis was closely related to any stage of ROP (OR = 1.57, 95% CI 1.31 to 1.89) and severe stage of ROP (OR = 2.33, 95% CI 1.21 to 4.51) in premature infants, with 56.3% and 81.8% heterogeneity, respectively. Subgroup analyses showed that heterogeneity was obvious in prospective cohort studies (I2= 62.1%, p<0.001). In a sensitivity analysis, we found that removing any single study did not significantly change the overall effect value. The quality of the evidence was rated as low for both any stage of ROP and severe stage of ROP.ConclusionsSepsis increases the risk of ROP in preterm infants. However, considering that all included studies are observational and causality can rarely be established, additional evidence is needed to substantiate this finding and provide advice for practice.

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