| Chorioamnionitis as a risk factor for cerebral palsy: A meta-analysis. | |
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MedLine Citation:
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PMID: 10989405 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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CONTEXT: Chorioamnionitis has been implicated in the pathogenesis of cerebral palsy, but most studies have not reported a significant association. Cystic periventricular leukomalacia (cPVL) is believed to be a precursor of cerebral palsy in preterm infants. OBJECTIVES: To determine whether chorioamnionitis is associated with cerebral palsy or cPVL and to examine factors that may explain differences in study results. DATA SOURCES: Searches of MEDLINE (1966-1999), Index Medicus (1960-1965), Doctoral Dissertation Abstracts On-Line (1861-1999), bibliographies, and online conference proceedings (1999) were performed for English-language studies with titles or abstracts that discussed prenatal risk factors for cerebral palsy or cPVL. STUDY SELECTION: Of 229 initially identified publications, meta-analyses were performed on studies that addressed the association between clinical (n = 19) or histologic (n = 7) chorioamnionitis and cerebral palsy or cPVL in both preterm and full-term infants. Inclusion criteria were: presence of appropriate exposure and outcome measures, case-control or cohort study design, and provision of sufficient data to calculate relative risks (RRs) or odds ratios with 95% confidence intervals (CIs). Studies evaluating risk of cerebral palsy following maternal fever, urinary tract infection, or other maternal infection were collected, but not included in the meta-analysis. DATA EXTRACTION: Information from individual studies was abstracted using standardized forms by 2 independent observers blinded to authors' names, journal titles, and funding sources. DATA SYNTHESIS: Using a random effects model, clinical chorioamnionitis was significantly associated with both cerebral palsy (RR, 1.9; 95% CI, 1.4-2.5) and cPVL (RR, 3.0; 95% CI, 2.2-4.0) in preterm infants. The RR of histologic chorioamnionitis and cerebral palsy was 1.6 (95% CI, 0.9-2.7) in preterm infants, and histologic chorioamnionitis was significantly associated with cPVL (RR, 2.1; 95% CI, 1.5-2.9). Among full-term infants, a positive association was found between clinical chorioamnionitis and cerebral palsy (RR, 4.7; 95% CI, 1.3-16.2). Factors explaining differences in study results included varying definitions of clinical chorioamnionitis, extent of blinding in determining exposure status, and whether individual studies adjusted for potential confounders. CONCLUSION: Our meta-analysis indicates that chorioamnionitis is a risk factor for both cerebral palsy and cPVL. JAMA. 2000;284:1417-1424. |
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Authors:
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Y W Wu; J M Colford |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, U.S. Gov't, P.H.S.; Review |
Journal Detail:
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Title: JAMA : the journal of the American Medical Association Volume: 284 ISSN: 0098-7484 ISO Abbreviation: JAMA Publication Date: 2000 Sep |
Date Detail:
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Created Date: 2000-10-03 Completed Date: 2000-10-03 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 7501160 Medline TA: JAMA Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1417-24 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurology, University of California, PO Box 0114, San Francisco, CA 94143-0114, USA. yvonne@itsa.ucsf.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cerebral Palsy
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epidemiology,
etiology* Chorioamnionitis / complications* Female Humans Infant, Newborn Infant, Premature Leukomalacia, Periventricular / epidemiology, etiology* Pregnancy Risk Factors |
| Grant Support | |
ID/Acronym/Agency:
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5 K12 NS01692-05/NS/NINDS NIH HHS |
| Comments/Corrections | |
Comment In:
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JAMA. 2000 Dec 20;284(23):2996-7
[PMID:
11122581
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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