48: Is Chorioamnionitis a Risk Factor for Retinopathy of Prematurity?: Lessons from a Meta-Analytical Review
Notice bibliographique
Résumé
The role of chorioamnionitis (CA) in the development of retinopathy of prematurity (ROP) has not been well established. To conduct a systematic review and meta-analysis of the association between CA and ROP in preterm infants. Data Sources: The authors searched Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials and PubMed, reviewed reference lists of relevant articles, abstracts and conference proceedings (Society for Pediatric Research, European Society for Paediatric Research 1990 to 2012) and seeking results of unpublished trials, and contacted the primary authors of relevant studies. Studies were included if they had a comparison group, examined preterm infants, and reported primary data that could be used to measure the association between exposure to CA and the development of ROP. Two reviewers independently screened the search results, applied inclusion criteria and assessed methodological quality using the Newcastle-Ottawa scale. One reviewer extracted data and a second reviewer checked data extraction. Summary relative risks (RRs) were calculated using a random effects model. We identified 1249 potentially relevant studies from the electronic databases. Twenty seven studies involving 10,590 preterm neonates with 2562 cases of ROP were included. Taking into account all included studies without adjusting for gestational age (GA), CA was significantly associated with ROP (any stage) (summary RR 1.33 [95% CI 1.14 to 1.55], I2=77%, pheterogeneity <0.0001)] and a borderline significant association was observed for severe ROP (stage >3) (summary RR 1.27 [95% CI 0.99 to 1.63], I2=74%, pheterogeneity<0.0001). There was no publication bias with Begg's test. However, subgroup analysis of studies adjusting for GA shows no significant association on CA with ROP (summary RR 0.98 [95% CI 0.77 to 1.26], I2=0%, pheterogeneity=0.89). Unadjusted analyses showed that CA was significantly associated with ROP(any stage) as well as with severe ROP (> stage 3). However the association disappeared on analysis of studies adjusting for GA. Hence CA cannot be definitively considered as a risk factor for ROP and further studies should adjust for potential confounding factors to clarify the association with severe ROP. This study underlies the importance of taking into account all possible sources of heterogeneity across studies while interpreting the results of a meta-analysis. Forest plot for 27 studies examining the effect of CA (any type) on ROP (any stage). RR>1 indicates increased risk of ROP in infants born to mothers with CA Forest plot for stratified analysis of eight studies (adjusted for GA) examining the effect of CA on ROP. RR>1 indicates increased risk of ROP in infants born to mothers with CA
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,017 | 0,007 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».