Chorioamnionitis as a risk factor for cerebral palsy: A meta-analysis

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Pediatric Neurology

Background:

• Chorioamnionitis is a suspected contributor to cerebral palsy pathogenesis, though prior studies yielded inconsistent results.
• Cystic periventricular leukomalacia (cPVL) is a recognized precursor to cerebral palsy in preterm neonates.

Purpose of the Study:

• To investigate the association between chorioamnionitis and cerebral palsy or cPVL.
• To identify factors contributing to discrepancies in previous research findings.

Main Methods:

• A comprehensive literature search was conducted across multiple databases for relevant English-language studies.
• Meta-analyses were performed on clinical and histologic chorioamnionitis data from case-control and cohort studies.
• Inclusion criteria ensured appropriate exposure/outcome measures and data for risk calculations.

Main Results:

• Clinical chorioamnionitis showed a significant association with cerebral palsy (RR 1.9) and cPVL (RR 3.0) in preterm infants.
• Histologic chorioamnionitis was significantly linked to cPVL (RR 2.1) in preterm infants.
• Clinical chorioamnionitis was associated with cerebral palsy in full-term infants (RR 4.7).

Conclusions:

• Chorioamnionitis is confirmed as a risk factor for both cerebral palsy and cPVL.
• Variations in study methodologies, definitions, and confounder adjustments influenced prior results.