支气管肺发育不良(BPD)是极早产儿(VPI)或极低出生体重(VLBW)婴儿最常见的严重并发症。研究表明病毒感染在病因发生中。本研究的目的是通过系统评价和荟萃分析总结病毒感染与BPD之间的关系。我们搜索了PubMed,Embase,WebofScience核心合集,和2023年12月19日的Cochrane数据库。我们纳入了观察性研究,这些研究检查了早产儿病毒感染与BPD之间的关系。我们提取了研究方法的数据,参与者特征,暴露评估,和结果措施。我们使用纽卡斯尔-渥太华量表(NOS)评估研究偏倚风险。我们在定性综述和荟萃分析中纳入了17项和15项研究,分别。荟萃分析显示病毒感染与月经后36周龄诊断的BPD之间存在显着关联(优势比(OR):2.42,95%置信区间:1.89-3.09,13项研究,证据的确定性非常低)。在特定病毒的亚组分析中,巨细胞病毒(CMV)被证明与月经后36周龄时诊断的BPD显着相关(OR:2.34,95%置信区间:1.80-3.05,11项研究)。我们没有发现病毒感染和出生后第28天诊断的BPD之间的关联,可能是由于纳入的前瞻性研究样本量小。结论:病毒感染,尤其是CMV,与早产儿BPD风险增加相关。需要具有大样本的方法可靠的前瞻性研究来验证我们的结论,需要高质量的随机对照研究来探讨预防或治疗病毒感染对BPD发病率的影响。研究试图确定早产儿的病毒感染和支气管肺发育不良;然而,结果不一致。新增内容:•系统证明病毒感染,特别是巨细胞病毒,与月经后第36周龄早产儿诊断的支气管肺发育不良呈正相关。•筛查早产儿病毒感染的重要性,尤其是巨细胞病毒.未来应进行更多高质量的研究,以研究病毒感染与支气管肺发育不良之间的因果关系。
Bronchopulmonary dysplasia (BPD) is the most common serious complication of very preterm infants (VPI) or very low birth weight (VLBW) infants. Studies implicate viral infections in etiopathogenesis. The aim of this study was to summarize the relationship between viral infections and BPD through a systematic
review and meta-analysis. We searched PubMed, Embase, the Web of Science Core Collection, and the Cochrane Database on December 19, 2023. We included observational studies that examined the association between viral infections and BPD in preterm infants. We extracted data on study methods, participant characteristics, exposure assessment, and outcome measures. We assessed study risk of bias using the Newcastle-Ottawa Scale (NOS). We included 17 and 15 studies in the qualitative
review and meta-analysis, respectively. The meta-analysis showed a significant association between viral infection and BPD diagnosed at 36 weeks postmenstrual age (odds ratio (OR): 2.42, 95% confidence interval: 1.89-3.09, 13 studies, very low certainty of evidence). In a subgroup analysis of specific viruses,
cytomegalovirus (CMV) proved to be significantly associated with BPD diagnosed at 36 weeks postmenstrual age (OR: 2.34, 95% confidence interval: 1.80-3.05, 11 studies). We did not find an association between viral infection and BPD diagnosed on the 28th day of life, probably due to the small sample size of the included prospective studies. Conclusion: Viral infections, especially CMV, are associated with an increased risk of BPD in preterm infants. Methodologically reliable prospective studies with large samples are needed to validate our conclusions, and high-quality randomized controlled studies are needed to explore the effect of prevention or treatment of viral infections on the incidence of BPD. What is Known: • Studies have attempted to identify viral infections and bronchopulmonary dysplasia in preterm infants; however, results have been inconsistent. What is New: • Systematic demonstration that viral infections, particularly
cytomegalovirus, are positively associated with bronchopulmonary dysplasia diagnosed in preterm infants at the 36th week of postmenstrual age. • The importance of screening for viral infections in preterm infants, especially
cytomegalovirus. More high-quality studies should be produced in the future to investigate the causal relationship between viral infections and bronchopulmonary dysplasia.