Association between pulmonary ureaplasma colonization and bronchopulmonary dysplasia in preterm infants: updated systematic review and meta-analysis.
BACKGROUND
Previous meta-analyses have reported a significant association between pulmonary colonization with Ureaplasma and development of bronchopulmonary dysplasia (BPD). However, because few studies reporting oxygen dependency at 36 weeks corrected gestation were previously available, we updated the systematic review and meta-analyses to evaluate the association between presence of pulmonary Ureaplasma and development of BPD.


METHODS
Five databases were searched for articles reporting the incidence of BPD at 36 weeks postmenstrual age (BPD36) and/or BPD at 28 days of life (BPD28) in Ureaplasma colonized and noncolonized groups. Pooled estimates were produced using random effects meta-analysis. Meta-regression was used to assess the influence of difference in gestational age between the Ureaplasma-positive and Ureaplasma-negative groups. The effects of potential sources of heterogeneity were also investigated.


RESULTS
Of 39 studies included, 8 reported BPD36, 22 reported BPD28 and 9 reported both. The quality of studies was assessed as moderate to good. There was a significant association between Ureaplasma and development of BPD36 (odds ratio = 2.22; 95% confidence intervals: 1.42-3.47) and BPD28 (odds ratio = 3.04; 95% confidence intervals: 2.41-3.83). Sample size influenced the odds ratio, but no significant association was noted between BPD28 rates and difference in gestational age between Ureaplasma colonized and noncolonized infants (P = 0.96).


CONCLUSIONS
Pulmonary colonization with Ureaplasma continues to be significantly associated with development of BPD in preterm infants at both 36 weeks postmenstrual age and at 28 days of life. This association at BPD28 persists regardless of difference in gestational age.
From the *Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom; and †Department of Pediatric Pharmacology and Pharmacogenetics, Hôpital Robert Debré, Paris, France.
John
J
Lowe
W John
WJ
Watkins
Martin O
MO
Edwards
O Brad
OB
Spiller
Evelyne
E
Jacqz-Aigrain
Sarah J
SJ
Kotecha
Sailesh
S
Kotecha
D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology*; D002353:Carrier State / Q000453:epidemiology*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D014509:Ureaplasma / Q000302:isolation & purification*; D016869:Ureaplasma Infections / Q000453:epidemiology*