Reproduction, Mother and Child Health Unit, CHU de Québec-Université Laval Research Center, Université Laval, 2705, Boul. Laurier, TR-66, Québec, QC, G1V 4G2, Canada.
Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, 1050, Avenue de la Médecine, Québec, QC, G1V 0A6, Canada.
Syst Rev. 2018 Jan 22;7(1):12. doi: 10.1186/s13643-018-0683-z.
Intra-amniotic inflammation is associated with adverse pregnancy and neonatal outcomes. However, the impact on child neurodevelopment remains unclear. We aim to assess the effect of intra-amniotic inflammation on neurodevelopmental outcomes in children.
The databases MEDLINE, Embase, CINAHL, and Cochrane will be searched from their inception until November 2017. Randomized trials and cohort studies in which inflammatory markers were measured in amniotic fluid collected by amniocentesis and in which infant's neurodevelopment was assessed will be eligible. Two reviewers will independently select eligible studies, assess their risk of bias, and extract data. Results will be compared and a third party will be consulted in case of disagreement. Our primary outcome of interest is child neurodevelopment, assessed with either a validated tool or by revision of medical records for specific diagnosis. Secondary outcomes will include abnormal brain imaging. Relative risks will be pooled and sensitivity analyses will be performed for the indication of amniocentesis, gestational age at amniocentesis, gestational age at delivery, and fetal sex. Risk of bias will be assessed using the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials or an adapted version of the ROBINS-1 for the risk of bias in non-randomized studies.
This systematic review will report the current evidence regarding the association between amniotic inflammation and child neurodevelopment, and the modifiers of this association. The review will generate new hypotheses on pathological pathways and will guide future research.
PROSPERO 2017 65065.
羊膜内炎症与不良妊娠和新生儿结局相关。然而，其对儿童神经发育的影响尚不清楚。我们旨在评估羊膜内炎症对儿童神经发育结局的影响。
我们将检索 MEDLINE、Embase、CINAHL 和 Cochrane 数据库，检索时间从建库至 2017 年 11 月。纳入研究为通过羊膜穿刺术采集羊水并检测其中炎症标志物，同时评估婴儿神经发育的随机试验和队列研究。两名评审员将独立筛选合格研究，评估其偏倚风险并提取数据。若结果存在差异，将进行比较并咨询第三方意见。我们主要关注的结局是儿童神经发育，使用经过验证的工具或通过查阅病历进行特定诊断进行评估。次要结局包括异常脑影像学。将汇总相对风险，并针对羊膜穿刺术指征、羊膜穿刺术时的孕龄、分娩时的孕龄和胎儿性别进行敏感性分析。将使用 Cochrane 协作组评估随机试验偏倚风险的工具或 ROBINS-1 评估非随机研究偏倚风险的改编版评估偏倚风险。
本系统综述将报告目前关于羊膜内炎症与儿童神经发育之间关联以及该关联的修饰因子的证据。该综述将提出关于病理途径的新假说，并指导未来的研究。
PROSPERO 2017 65065。
