Dataset Information

Association between bronchopulmonary dysplasia and cerebral palsy in children: a meta-analysis.

ABSTRACT: OBJECTIVE:To investigate the association between bronchopulmonary dysplasia (BPD) and the risk of cerebral palsy (CP) in children. DATA SOURCES:We used EMBASE, PubMed and Web of Science to conduct a meta-analysis of studies published before 1 September 2017, written in English whose titles or abstracts discussed an association between BPD and CP. STUDY SELECTION:Observational studies, for example, case-control and cohort studies were included. DATA EXTRACTION AND SYNTHESIS:All review stages were conducted by two reviewers independently. Data synthesis was undertaken via meta-analysis of available evidence. MAIN OUTCOMES AND MEASURES:The prevalence of developing CP was measured after exposure to BPD. RESULTS:Among 1234 initially identified studies, we selected those that addressed an association between BPD and CP according to our preselected inclusion criteria. Our meta-analysis included 11 studies. According to a random effect model, BPD was significantly associated with CP (ORs 2.10; 95%?CI 1.57 to 2.82) in preterm infants. Factors explaining differences in the study results included study design, the definition of BPD, the time of diagnosis of CP and whether the studies adjusted for potential confounders. CONCLUSION:This study suggests that BPD is a risk factor for CP. Further studies are required to confirm these results and to detect the influence of variables across studies.

SUBMITTER: Gou X

PROVIDER: S-EPMC6150141 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Association between bronchopulmonary dysplasia and cerebral palsy in children: a meta-analysis.

Gou Xiaoyun X Yang Lei L Pan Lingli L Xiao Dongqiong D

BMJ open 20180919 9

<h4>Objective</h4>To investigate the association between bronchopulmonary dysplasia (BPD) and the risk of cerebral palsy (CP) in children.<h4>Data sources</h4>We used EMBASE, PubMed and Web of Science to conduct a meta-analysis of studies published before 1 September 2017, written in English whose titles or abstracts discussed an association between BPD and CP.<h4>Study selection</h4>Observational studies, for example, case-control and cohort studies were included.<h4>Data extraction and synthes ...[more]

PMID: 30232102

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Project description:ImportanceBronchopulmonary dysplasia (BPD), a chronic lung disease of prematurity, remains one of the major and most common complications of very preterm birth. Insight into factors associated with the pathogenesis of BPD is key to improving its prevention and treatment.ObjectiveTo perform a systematic review, meta-analysis, and metaregression of clinical studies exploring the association between chorioamnionitis (CA) and BPD in preterm infants.Data sourcesPubMed and Embase were searched without language restriction (last search, October 1, 2018). Key search terms included bronchopulmonary dysplasia, chorioamnionitis, and risk factors.Study selectionIncluded studies were peer-reviewed studies examining preterm (<37 weeks' gestation) or very low-birth-weight (<1500 g) infants and reporting primary data that could be used to measure the association between exposure to CA and the development of BPD.Data extraction and synthesisThe Meta-analysis of Observational Studies in Epidemiology (MOOSE) guideline was followed. Data were independently extracted by 2 researchers. A random-effects model was used to calculate odds ratios (ORs) and 95% CIs. Heterogeneity in effect size across studies was studied using multivariate, random-effects metaregression analysis.Main outcomes and measuresThe primary outcome was BPD, defined as supplemental oxygen requirement on postnatal day 28 (BPD28) or at the postmenstrual age of 36 weeks (BPD36). Covariates considered as potential confounders included differences between CA-exposed and CA-unexposed infants in gestational age, rates of respiratory distress syndrome (RDS), exposure to antenatal corticosteroids, and rates of early- and late-onset sepsis.ResultsA total of 3170 potentially relevant studies were found, of which 158 met the inclusion criteria (244?096 preterm infants, 20?971 CA cases, and 24?335 BPD cases). Meta-analysis showed that CA exposure was significantly associated with BPD28 (65 studies; OR, 2.32; 95% CI, 1.88-2.86; P?<?.001; heterogeneity: I2?=?84%; P?<?.001) and BPD36 (108 studies; OR, 1.29; 95% CI, 1.17-1.42; P?<?.001; heterogeneity: I2?=?63%; P?<?.001). The association between CA and BPD remained significant for both clinical and histologic CA. In addition, significant differences were found between CA-exposed and CA-unexposed infants in gestational age, birth weight, odds of being small for gestational age, exposure to antenatal corticosteroids, and early- and late-onset sepsis. Chorioamnionitis was not significantly associated with RDS (48 studies; OR, 1.10; 95% CI, 0.92-1.34; P?=?.24; heterogeneity: I2?=?90%; P?<?.001), but multivariate metaregression analysis with backward elimination revealed that a model combining the difference in gestational age and the odds of RDS was associated with 64% of the variance in the association between CA and BPD36 across studies.Conclusions and relevanceThe results of this study confirm that among preterm infants, exposure to CA is associated with a higher risk of developing BPD, but this association may be modulated by gestational age and risk of RDS.

Project description:IntroductionCerebral palsy (CP) is the most common motor disability in childhood, but its causes are only partly known. Early-life exposure to toxic metals and inadequate or excess amounts of essential elements can adversely affect brain and nervous system development. However, little is still known about these as perinatal risk factors for CP. This study aims to investigate the associations between second trimester maternal blood levels of toxic metals, essential elements, and mixtures thereof, with CP diagnoses in children.MethodsIn a large, population-based prospective birth cohort (The Norwegian Mother, Father, and Child Cohort Study), children with CP diagnoses were identified through The Norwegian Patient Registry and Cerebral Palsy Registry of Norway. One hundred forty-four children with CP and 1,082 controls were included. The relationship between maternal blood concentrations of five toxic metals and six essential elements and CP diagnoses were investigated using mixture approaches: elastic net with stability selection to identify important metals/elements in the mixture in relation to CP; then logistic regressions of the selected metals/elements to estimate odds ratio (OR) of CP and two-way interactions among metals/elements and with child sex and maternal education. Finally, the joint effects of the mixtures on CP diagnoses were estimated using quantile-based g-computation analyses.ResultsThe essential elements manganese and copper, as well as the toxic metal Hg, were the most important in relation to CP. Elevated maternal levels of copper (OR = 1.40) and manganese (OR = 1.20) were associated with increased risk of CP, while Hg levels were, counterintuitively, inversely related to CP. Metal/element interactions that were associated with CP were observed, and that sex and maternal education influenced the relationships between metals/elements and CP. In the joint mixture approach no significant association between the mixture of metals/elements and CP (OR = 1.00, 95% CI = [0.67, 1.50]) was identified.ConclusionUsing mixture approaches, elevated levels of copper and manganese measured in maternal blood during the second trimester could be related to increased risk of CP in children. The inverse associations between maternal Hg and CP could reflect Hg as a marker of maternal fish intake and thus nutrients beneficial for foetal brain development.

Dataset Information

Association between bronchopulmonary dysplasia and cerebral palsy in children: a meta-analysis.

Publications

Association between bronchopulmonary dysplasia and cerebral palsy in children: a meta-analysis.

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