PT - JOURNAL ARTICLE AU - Eduardo Villamor-Martinez AU - Giacomo Cavallaro AU - Genny Raffaeli AU - Owais M. M. Mohammed Rahim AU - Amro M. T. Ghazi AU - Fabio Mosca AU - Pieter Degraeuwe AU - Eduardo Villamor TI - Chorioamnionitis as a risk factor for retinopathy of prematurity: an updated systematic review and meta-analysis AID - 10.1101/291476 DP - 2018 Jan 01 TA - bioRxiv PG - 291476 4099 - http://biorxiv.org/content/early/2018/03/31/291476.short 4100 - http://biorxiv.org/content/early/2018/03/31/291476.full AB - The role of chorioamnionitis (CA) in the development of retinopathy of prematurity (ROP) is difficult to establish, because CA-exposed and CA-unexposed infants frequently present different baseline characteristics. We performed an updated systematic review and meta-analysis of studies reporting on the association between CA and ROP. We searched PubMed and EMBASE for relevant articles. Studies were included if they examined preterm or very low birth weight (VLBW, <1500g) infants and reported primary data that could be used to measure the association between exposure to CA and the presence of ROP. Of 748 potentially relevant studies, 50 studies met the inclusion criteria (38,986 infants, 9,258 CA cases). Meta-analysis showed a significant positive association between CA and any stage ROP (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.11 to 1.74). CA was also associated with severe (stage ≥3) ROP (OR 1.63, 95% CI 1.41 to 1.89). Exposure to funisitis was associated with a higher risk of ROP than exposure to CA in the absence of funisitis. Additional meta-analyses showed that infants exposed to CA had lower gestational age (GA) and lower birth weight (BW). Meta-regression showed that lower GA and BW in the CA-exposed group was significantly associated with a higher risk of ROP. In conclusion, our study confirms that CA is a risk factor for developing ROP. However, part of the effects of CA on the pathogenesis of ROP may be mediated by the role of CA as an etiological factor for very preterm birth.