Placenta Microbiology and Histology and the Risk for Severe Retinopathy of Prematurity

Chen, Minghua L; Allred, Elizabeth N.; Hecht, Jonathan L.; Onderdonk, Andrew B.; VanderVeen, Deborah K.; Wallace, David K.; Leviton, Alan; Dammann, Olaf

doi:10.1167/iovs.11-7380

Cited by 71 publications

(63 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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%

“…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 rest of the studies evaluated the occurrence of ROP as one of the outcomes of clinical or histological CA. Additional information was collected by personal communication with the authors from 3 studies [39,51,52]. …”

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

View full text Add to dashboard Cite

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proceedings (Society for Pediatric Research, European Society for Paediatric Research 1990-2012), sought results of unpublished trials, and contacted the primary authors of relevant studies.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.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

Mitra

Aune²,

Speer³

et al. 2014

Neonatology

View full text Add to dashboard Cite

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

“…103 The increased risk associated with infection might be partly due to systemic inflammation, 10,104-106 which could act synergistically with hyperoxia 107 to mediate the effects of placenta infection. 53 Blood transfusions have also been suggested as a possible risk factor for retinopathy of prematurity, 108,109 but investigators of the only clinical trial that assessed this question reported no evidence of a link. 110 Genetic factors might also affect risk for retinopathy of prematurity.…”

Section: Other Risk Factorsmentioning

confidence: 99%

Retinopathy of Prematurity

Stahl¹,

Hellström²,

Smith³

2016

Anti-Angiogenic Therapy in Ophthalmology

View full text Add to dashboard Cite

The immature retinas of preterm newborns are susceptible to insults that disrupt neurovascular growth, which leads to retinopathy of prematurity. Suppression of growth factors due to hyperoxia and loss of the maternal-fetal interaction result in an arrest of retinal vascularisation (phase 1). Subsequently, the increasingly metabolically active, yet poorly vascularised, retina becomes hypoxic, stimulating growth factor-induced vasoproliferation (phase 2), which can cause retinal detachment. In very premature infants, controlled oxygen administration reduces but does not eliminate retinopathy of prematurity. Identification and control of factors that contribute to development of retinopathy of prematurity is essential to prevent progression to severe sightthreatening disease and to limit comorbidities with which the disease shares modifiable risk factors. Strategies to prevent retinopathy of prematurity will depend on optimisation of oxygen saturation, nutrition, and normalisation of concentrations of essential factors such as insulin-like growth factor 1 and ω-3 polyunsaturated fatty acids, as well as curbing of the effects of infection and inflammation to promote normal growth and limit suppression of neurovascular development.

show abstract

Placenta Microbiology and Histology and the Risk for Severe Retinopathy of Prematurity

Abstract: While antenatal exposure to infection or inflammation alone does not appear to convey risk information for severe ROP, their co-occurrence does. This finding supports the hypothesis that a fetal inflammatory response to antenatal infection might be part of the etiology of severe ROP.

Cited by 71 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

The Human Ureaplasma Species as Causative Agents of Chorioamnionitis

Retinopathy of Prematurity

Contact Info

Product

Resources

About