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That chorioamnionitis is a risk factor for bronchopulmonary dysplasia--the case against

Thierry Lacaze-Masmonteil1

  • 1Department of Pediatrics and Research Institute, Children's Hospital of Eastern Ontario, University of Ottawa, Canada.

Paediatric Respiratory Reviews
|October 15, 2013
PubMed

Insights

Bronchopulmonary dysplasia (BPD) is a common infant lung condition. Evidence does not definitively link histological chorioamnionitis (CA) to an increased BPD risk, especially after accounting for confounding factors.

Area of Science:

  • Neonatalogy
  • Pediatric Pulmonology
  • Perinatal Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in preterm infants.
  • Histological chorioamnionitis (CA) is frequently observed in very preterm births.
  • The association between CA and BPD risk remains debated due to conflicting study results.

Purpose of the Study:

  • To evaluate the association between histological chorioamnionitis (CA) and the risk of developing bronchopulmonary dysplasia (BPD).
  • To synthesize evidence considering confounding factors and publication bias.

Main Methods:

  • Systematic review and meta-analysis of existing studies.
  • Analysis of results adjusted for confounders like gestational age and antenatal steroids.
  • Assessment for publication bias.

Main Results:

  • Initial meta-analysis suggested a potential association between CA and BPD.
  • Adjusting for confounders and publication bias yielded more conservative results.
  • Recent large cohort studies and adjusted analyses did not support CA as a significant risk factor for BPD.

Conclusions:

  • The link between histological chorioamnionitis and an increased risk of bronchopulmonary dysplasia is not definitively established.
  • Confounding factors and publication bias complicate the interpretation of existing data.
  • Current evidence does not support CA as a confirmed risk factor for BPD in very preterm infants.

Keywords:
Bronchopulmonary dysplasiaChorioamnionitisNeonatePreterm infant

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