Antenatal infection and intraventricular hemorrhage in preterm infants: A meta-analysis

BACKGROUND: The aim of this study was to summarize current evidence evaluating the association between antenatal infection and intraventricular hemorrhage (IVH) in preterm infants. MATERIALS AND METHODS: We searched for published articles on antenatal infection and IVH in 3 English (PubMed, the Cochrane Library, and EBSCO) and 3 Chinese (VEIPU, CNKI, and WANFANG) databases on May 19, 2019. In addition, the references of these articles were screened. The included studies had to meet all of the following criteria: preterm infants (<37 weeks); comparing antenatal infection with no infection; the outcomes included IVH (all grades), mild IVH, or sereve IVH; the type of study was randomized controlled trial or cohort study. RESULTS: A total of 23 cohort studies involving 13,605 preterm infants met our inclusion criteria. Antenatal infection increased the risk of IVH (odds ratios ([OR] 2.18, 95% confidence intervals [CI] 1.58–2.99), mild IVH (OR 1.95, 95% CI 1.09–3.49) and severe IVH (OR 2.65, 95% CI 1.52–4.61). For type of antenatal infection, the ORs and 95% CI were as follows: 2.21 (1.60–3.05) for chorioamnionitis, 2.26 (1.55–3.28) for histologic chorioamnionitis, 1.88 (1.22–2.92) for clinical chorioamnionitis, and 1.88 (1.14–3.10) for ureaplasma. CONCLUSIONS: Antenatal infection may increase the risk of developing IVH in the preterm infant. The evidence base is however of low quality and well-designed studies are needed.