Histologic chorioamnionitis and severity of illness in very low birth weight newborns

Felice, Claudio De; Toti, Paolo; Parrini, Stefano; Vecchio, Antonio Del; Bagnoli, Fábio; Latini, Giuseppe; Kopotic, Robert J.

doi:10.1097/01.pcc.0000160658.35437.65

Cited by 49 publications

(46 citation statements)

References 39 publications

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“…In 19 of 27 studies, the patient characteristics were clearly differentiated between the CA and non-CA groups. In 15 out of these 19 studies, there was a significantly higher GA at birth among the non-CA group compared to the CA group [21,27,28,36,41,43,45,56,57,58,60,62,63,64,65]. Only 8 studies showed no difference among the groups in terms of GA [42,43,47,50,52,58,61,66].…”

Section: Methodsmentioning

confidence: 99%

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Chorioamnionitis as a Risk Factor for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Mitra

Aune²,

Speer³

et al. 2014

Neonatology

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Background: The role of chorioamnionitis (CA) in the development of retinopathy of prematurity (ROP) has not been well established. Objective: 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proceedings (Society for Pediatric Research, European Society for Paediatric Research 1990-2012), sought results of unpublished trials, and contacted the primary authors of relevant studies. Study Selection: 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. Data Extraction: 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. Data Synthesis: We identified 1,249 potentially relevant studies from the electronic databases. Twenty-seven studies involving 10,590 preterm neonates with 2,562 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 1.14-1.55, I² = 77%, p_{heterogeneity} < 0.0001)], and a borderline significant association was observed for severe ROP (stage ≥3) [summary RR 1.27 (95% CI 0.99-1.63, I² = 74%, p_{heterogeneity} < 0.0001)]. There was no publication bias with Begg's test. However, subgroup analysis of studies adjusting for GA showed no significant association on CA with ROP [summary RR 0.98 (95% CI 0.77-1.26, I² = 0%, p_{heterogeneity} = 0.89)]. Conclusion: 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 and report results by stage to clarify the association with severe ROP.

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Section: Methodsmentioning

confidence: 99%

“…The clinical profile of the infants and the methodological characteristics of the studies have been summarized in online supplementary appendix A (see www.karger.com/doi/10.1159/000357556 for all online suppl. material) [36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69]. …”

Section: Methodsmentioning

confidence: 99%

Chorioamnionitis as a Risk Factor for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Mitra

Aune²,

Speer³

et al. 2014

Neonatology

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“…It effects are likely mediated by a fetal inflammatory response syndrome with multiple organ failure and dysfunction (4). CA can be considered a "natural" model for neonatal illness severity in high-risk newborns admitted to the neonatal intensive care unit (NICU) (5)(6)(7)(8)(9)(10)(11).…”

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confidence: 99%

Early dynamic changes in pulse oximetry signals in preterm newborns with histologic chorioamnionitis

Felice

Goldstein²,

Parrini³

et al. 2006

Pediatric Critical Care Medicine

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“…In particular, a PI value of ^ 1.24 has been shown to be an accurate predictor for assessing the severity of neonatal illness [5] . In addition, early PI monitoring has been shown to be helpful in iden-tifying preterm and term neonates born to mothers with chorioamnionitis, a major predictor of morbidity and mortality in very low birth weight infants [8][9][10] . Moreover, PI values might be a useful additional tool for early detection of duct-dependent systemic circulation (left heart obstructive disease) [11] .…”

Section: Introductionmentioning

confidence: 99%

First Day of Life Reference Values for Pleth Variability Index in Spontaneously Breathing Term Newborns

2011

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Background: The perfusion index (PI), derived from the pulse oximetry signal, has been shown to be an accurate predictor for identifying high illness severity in neonates. The plethysmographic variability index (PVI) is a measure of the dynamic change in PI occurring during a complete respiratory cycle. Objectives: The aim of this study was to establish the reference range of PVI in spontaneously breathing term newborns. Methods: PI and PVI values were assessed in 242 term newborns during the first day of life. Results: The median PVI value on the first day of life was 20% [95% confidence interval (CI) for the mean 19–20%; inter-quartile range 15 (95% CI 15–16) – 24 (95% CI 23–24)]. The 10th and 90th percentile cutoff values were 12% (95% CI 11–12) and 28% (95% CI 27–29), respectively, with the 97.5th percentile of 35% (95% CI 34–38). PVI was also significantly influenced by the behavioral status of the newborn, and was positively correlated with PI and pulse rate, while it was inversely correlated with oxygen saturation (p < 0.0001). Conclusions: Our findings suggest: (1) evaluation of PVI values is an easily applicable, noninvasive procedure for monitoring early postnatal respiratory changes in newborns, and (2) the feasibility of a noninvasive pulse-oximeter postnatal screening for early identification of adverse neonatal cardiorespiratory outcomes.

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Histologic chorioamnionitis and severity of illness in very low birth weight newborns

Abstract: Our findings indicate that HCA is a major predictor of morbidity and mortality in VLBW newborns.

Cited by 49 publications

References 39 publications

Chorioamnionitis as a Risk Factor for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Chorioamnionitis as a Risk Factor for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Early dynamic changes in pulse oximetry signals in preterm newborns with histologic chorioamnionitis

First Day of Life Reference Values for Pleth Variability Index in Spontaneously Breathing Term Newborns

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