组织学绒毛膜羊膜炎对早产儿支气管肺发育不良影响的Meta分析

A meta-analysis of the effects of histological chorioamnionitis on bronchopulmonary dysplasia in premature infants

目的探讨孕母组织学绒毛膜羊膜炎(histological chorioamnionitis,HCA)与早产儿支气管肺发育不良(bronchopulmonary dysplasia,BPD)之间的关系。方法计算机检索PubMed、Embase、Cochrane Library、维普、中国知网、中华医学期刊全文数据库和万方数据库自建库至2023年10月关于孕母HCA与新生儿BPD之间相关性的队列研究,采用Newcastle-Ottawa Scale量表对纳入文献进行质量评价,应用RevMan 5.4软件进行Meta分析。结果共纳入7篇文献,1535例早产儿,其中HCA组943例,非HCA组592例。HCA组BPD发生率显著高于非HCA组(RR=2.45,95%CI 1.74~3.44,P<0.001),HCA组脑室内出血(RR=1.63,95%CI 1.11~2.38,P=0.01)、新生儿坏死性小肠结肠炎(RR=1.94,95%CI 1.03~3.65,P=0.04)和新生儿早发败血症(RR=2.06,95%CI 1.50~2.84,P<0.001)的发生率也高于非HCA组。结论孕母HCA显著提高新生儿发生BPD的风险,并增加其他相关并发症的风险。

ObjectiveTo explore the relationship between maternal histological chorioamnionitis(HCA)and bronchopulmonary dysplasia(BPD)in premature infants.MethodsThe cohort studies on the correlation between maternal HCA and neonatal BPD from PubMed,Embase,Cochrane Library,VIP,CNKI,Chinese Medical Journal Full-text Database and Wanfang Database were searched by until October 2023.Newcastle-Ottawa Scale was used to evaluate the quality of the included literature,and the RevMan 5.4 software was used for meta-analysis.ResultsA total of 7 articles were included,with 1535 premature infants,including 943 in the HCA group and 592 in the non-HCA group.The incidence of BPD in HCA group was higher than that in non-HCA group,the difference was significant(RR=2.45,95%CI 1.74-3.44,P<0.001),intraventricular hemorrhage(RR=1.63,95%CI 1.11-2.38,P=0.01),neonatal necrotizing enterocolitis(RR=1.94,95%CI 1.03-3.65,P=0.04)and early onset sepsis(RR=2.06,95%CI 1.50-2.84,P<0.001)were also higher than those in the non-HCA group.ConclusionsMaternal HCA significantly increases the risk of neonatal BPD and other related complications.