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Systematic review of chorioamnionitis and cerebral palsy
1Department of Neurology, University of California at San Francisco, San Francisco, California 94143-0136, USA. yvonne@itsa.ucsf.edu
Insights
Chorioamnionitis, an infection during pregnancy, is a significant risk factor for cerebral palsy and cystic periventricular leukomalacia (cPVL) in newborns. This updated analysis confirms this link, highlighting the need for further research into its causes.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Neurology
- Perinatal Medicine
Background:
- Chorioamnionitis is a known risk factor for adverse neonatal outcomes.
- Cerebral palsy (CP) and cystic periventricular leukomalacia (cPVL) are serious neurological conditions affecting infants.
- Previous meta-analyses suggested a link between chorioamnionitis and CP/cPVL.
Purpose of the Study:
- To update a previous meta-analysis on chorioamnionitis and cerebral palsy.
- To include studies published up to the year 2000.
- To investigate sources of heterogeneity in the association between chorioamnionitis and cerebral palsy/cPVL.
Main Methods:
- A random effects model was employed for the meta-analysis.
- Studies published up to the year 2000 were included.
- Heterogeneity among study results was assessed.
Main Results:
- Clinical chorioamnionitis showed a significant association with cerebral palsy (RR 1.9, 95% CI 1.5-2.5).
- Clinical chorioamnionitis was also significantly associated with cystic periventricular leukomalacia (RR 2.6, 95% CI 1.7-3.9).
- Sources of heterogeneity included diagnostic practices, gestational age, and study year.
Conclusions:
- Chorioamnionitis is confirmed as a significant risk factor for both cerebral palsy and cystic periventricular leukomalacia.
- Variations in diagnostic criteria and study characteristics contribute to heterogeneity.
- Further research is warranted to understand the mechanisms and mitigate risks.
Abstract:
In a recent meta-analysis evaluating the relationship between chorioamnionitis and cerebral palsy, we found that chorioamnionitis is a risk factor for both cerebral palsy and cystic periventricular leukomalacia (cPVL). The current paper extends the meta-analysis by including studies published in the year 2000, and by further evaluating the causes of heterogeneity among individual study results. Using a random effects model, clinical chorioamnionitis was significantly associated with both cerebral palsy (RR 1.9, 95% CI 1.5-2.5) and cPVL (RR 2.6, 95% CI 1.7-3.9). Sources of heterogeneity included widely varying practices in the diagnosis of clinical chorioamnionitis, different gestational age characteristics, and varying study year. We conclude that based on the available literature, chorioamnionitis is a risk factor for both cerebral palsy and cPVL.