Effects of maternal and placental inflammation on retinopathy of prematurity

Woo, Se Joon; Park, Kyo Hoon; Jung, Hee Jung; Kim, Shi Nae; Choe, Gheeyoung; Ahn, Jeeyun; Park, Kyu Hyung

doi:10.1007/s00417-011-1648-2

Cited by 53 publications

(48 citation statements)

References 40 publications

(56 reference statements)

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“…On the other hand, increased cytokine levels in the first 72 h of life (IL-6 >357 pg/ml, IL-8 >216 pg/ml, and TNF-α >245 pg/ml) have been linked with development of severe ROP [75]. It has also been observed that maternal systemic inflammation leads to decreased levels of insulin-like growth factor-1, which in turn is associated with an increased risk of developing ROP [68,76]. Cytokine levels in the vitreous of 19 patients with stage 4 ROP were recently analyzed by Sato et al [77], who demonstrated that increased levels of vascular endothelial growth factor had the highest correlation with vascular activity in ROP eyes compared to other cytokines.…”

Section: Discussionmentioning

confidence: 99%

“…Eight studies defined both clinical as well as histological CA [42,43,44,50,52,56,61,68]. Two studies dealt with only clinical CA [26,28], while the rest of the studies only defined histological CA.…”

Section: Methodsmentioning

confidence: 99%

“…While all the studies provided data to measure the association between ROP and CA, the objectives of the studies varied. The risk factors for developing ROP in preterm infants were studied in 4 studies [26,39,51,68]. The rest of the studies evaluated the occurrence of ROP as one of the outcomes of clinical or histological CA.…”

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%

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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: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

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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“…In human studies, chorioamnionitis has been associated with neonatal death (27,86), early-onset neonatal sepsis (86)(87)(88), intrauterine growth restriction (89), poor neonatal growth (90), neurologic impairment/injury (91,92), intraventricular hemorrhage (86), bronchopulmonary dysplasia (93)(94)(95), patent ductus arteriosus (86,89,93,96), retinopathy of prematurity (89,97,98), cardiovascular abnormalities (99, 100), necrotizing enterocolitis (101,102), and dermatitis (103). However, low gestational age is often a significant contributing factor (104)(105)(106), and therefore, it is difficult to attribute these sequelae solely to chorioamnionitis.…”

Section: Neonatal Sequelae Of Chorioamnionitismentioning

confidence: 99%

The Human Ureaplasma Species as Causative Agents of Chorioamnionitis

et al. 2017

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SUMMARY The human Ureaplasma species are the most frequently isolated microorganisms from the amniotic fluid and placentae of women who deliver preterm and are also associated with spontaneous abortions or miscarriages, neonatal respiratory diseases, and chorioamnionitis. Despite the fact that these microorganisms have been habitually found within placentae of pregnancies with chorioamnionitis, the role of Ureaplasma species as a causative agent has not been satisfactorily explained. There is also controversy surrounding their role in disease, particularly as not all women infected with Ureaplasma spp. develop chorioamnionitis. In this review, we provide evidence that Ureaplasma spp. are associated with diseases of pregnancy and discuss recent findings which demonstrate that Ureaplasma spp. are associated with chorioamnionitis, regardless of gestational age at the time of delivery. Here, we also discuss the proposed major virulence factors of Ureaplasma spp., with a focus on the multiple-banded antigen (MBA), which may facilitate modulation/alteration of the host immune response and potentially explain why only subpopulations of infected women experience adverse pregnancy outcomes. The information presented within this review confirms that Ureaplasma spp. are not simply “innocent bystanders” in disease and highlights that these microorganisms are an often underestimated pathogen of pregnancy.

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The Male to Female Ratio in Treatment-Warranted Retinopathy of Prematurity

et al. 2022

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ImportanceLiterature and anecdotal evidence suggest a relationship between male sex and retinopathy of prematurity (ROP). It is not known whether a difference, if present, is sex-related pathophysiologic predisposition or sex difference in meeting ROP screening criteria.ObjectiveTo evaluate the association of sex with the development of treatment-warranted ROP.Data SourcesPubMed, Embase, and Web of Science databases were searched from 2000 to 2022. The search strategy used keywords including retinopathy of prematurity or ROP or retrolental fibroplasia and treatment or anti-VEGF or bevacizumab or ranibizumab or aflibercept or conbercept or laser or cryotherapy and gender or sex or male or female and medical subject headings terms.Study SelectionAll studies reporting on treatment with anti–vascular endothelial growth factor, laser photocoagulation, and/or cryotherapy for ROP were identified. Studies reporting sex distribution in the treatment group were included in the meta-analysis. Exclusion criteria included case reports, case series of fewer than 10 treated patients, systematic reviews, conference abstracts, letters to the editor, animal studies, and non-English records.Data Extraction and SynthesisTwo reviewers independently screened and extracted the data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The proportions of treated male and female infants were combined using random-effects meta-analysis.Main Outcomes and MeasuresNumbers and percentages of male and female infants treated for ROP.ResultsOf 11 368 identified studies, 316 met inclusion criteria, yielding a total of 31 026 treated patients. A higher percentage of male infants were treated for ROP (55% [95% CI, 0.54%-0.55%]), with low heterogeneity between studies (I2 = 34%; P &lt; .001). Thirty-eight studies reported sex distribution in the screened population (170 053 patients; 92 612 [53%] male vs 77 441 [47%] female). There was no significant difference in the odds of receiving treatment between screened male and female infants (pooled odds ratio, 1.04 [95% CI, 0.91-1.18]; P = .67).Conclusions and RelevanceMore male infants are treated for ROP than female infants. This could be due to a known relative pathophysiological fragility of preterm male infants in addition to a difference in ROP screening rates, with more male infants meeting the criteria than female infants. These findings have implications for future studies and may prompt more careful clinical monitoring of male neonates.

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Effects of maternal and placental inflammation on retinopathy of prematurity

Abstract: Clinical chorioamnionitis and elevated maternal WBC count, but not histologic chorioamnionitis, were significantly and independently associated with ROP. These findings support the hypothesis that maternal systemic inflammation may play a role in the pathogenesis of ROP.

Cited by 53 publications

References 40 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

The Human Ureaplasma Species as Causative Agents of Chorioamnionitis

The Male to Female Ratio in Treatment-Warranted Retinopathy of Prematurity

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