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Chorioamnionitis appears not to be a Risk Factor for Patent Ductus Arteriosus in Preterm Infants: A Systematic Review
Elham Behbodi1, Eduardo Villamor-Martínez1, Pieter L J Degraeuwe1
1Department of Pediatrics, Maastricht University Medical Center (MUMC+), School for Oncology and Developmental Biology (GROW), Maastricht, the Netherlands.
Scientific Reports
|November 29, 2016
Summary
Chorioamnionitis (CA) and patent ductus arteriosus (PDA) in preterm infants show a complex relationship. Confounders like gestational age significantly alter the observed association between CA and PDA.
Area of Science:
- Neonatal Medicine
- Perinatal Epidemiology
- Clinical Research
Background:
- Chorioamnionitis (CA) is a known risk factor for adverse outcomes in preterm infants.
- Observational studies on CA and patent ductus arteriosus (PDA) often have differing baseline characteristics, complicating assessment.
- The precise contribution of CA to PDA in preterm neonates requires careful consideration of confounding factors.
Purpose of the Study:
- To conduct a meta-analysis assessing the association between chorioamnionitis and patent ductus arteriosus in preterm infants.
- To evaluate the impact of potential confounders, specifically gestational age and birth weight, on this association.
- To provide a more accurate understanding of the relationship between CA and PDA, accounting for crucial variables.
Main Methods:
- A systematic meta-analysis of 45 relevant studies involving 27,186 patients was performed.
- Crude and adjusted odds ratios (ORs) for the association between CA and PDA were pooled.
- Meta-regression analysis was utilized to investigate the influence of gestational age and birth weight.
Main Results:
- Crude meta-analysis revealed a significant positive association between CA and PDA (OR 1.352).
- Meta-analysis of adjusted ORs from 11 studies showed a significant negative association (OR 0.802).
- Gestational age and birth weight were significantly correlated with the effect size, indicating their confounding role.
Conclusions:
- The observed association between chorioamnionitis and patent ductus arteriosus in preterm infants is significantly influenced by confounders.
- Adjusting for factors like gestational age and birth weight is crucial for accurately assessing the relationship.
- Future research and clinical assessments must account for these confounders to understand CA's true impact on PDA.
