Is chorioamnionitis associated with neurodevelopmental outcomes in preterm infants? A systematic review and meta-analysis following PRISMA

Abstract

Background:The relationships between chorioamnionitis (CA) and neurodevelopmental outcomes in preterm infants remain controversial. The meta-analysis aims to evaluate the associations between CA and neurodevelopmental deficits in preterm infants.Methods:All studies exploring the associations between CA and neurodevelopmental deficits in preterm infants were retrieved from the following databases: PubMed, Embase, OVID, EBSCO, ProQuest, CDSR, and CENTRAL. The NOS was used to evaluate the quality of the studies, RevMan was adopted to analyze the data.Results:Twelve studies involving 4267 preterm infants were included. The ORs across studies was 0.95 (P=.77, I2=51%) for cognitive deficits, 1.09 (P=.44, I2=10%) for psychomotor deficits, 1.21 (P=.08, I2=25%) for language deficits, 2.34 (P=.02, I2=0%) for performance intelligence quotient impairment and 2.81 (P=.03, I2=0%) for verbal intelligence quotient impairment. Subgroup analyses based on the severity of cognitive deficits indicated that CA might be correlated with severe cognitive deficits (P=.01, I2=0%) but not with mild cognitive deficits (P=.40, I2=19%). In terms of the CA category, clinical CA may be related to overall psychomotor deficits (P=.01, I2=25%) and overall language deficits (P