Association of Ureaplasma urealyticum colonization with chronic lung disease of prematurity: Results of a metaanalysis☆,☆☆,★
Section snippets
METHODS
All published studies were sought with the use of the MEDLINE bibliographic retrieval system (National Library of Medicine), Excerpta Medica, and Reference Update (Research Information Systems, Carlsbad, Calif.) by means of the MeSH (Medical Subject Headings thesaurus) terms “Ureaplasma urealyticum,” “Ureaplasma infections,” and “Bronchopulmonary dysplasia” for the years 1988 to 1994. The initial search was performed in June 1994 and updated in March 1995. Further studies identified in
RESULTS
Seventeen controlled studies were found in the search. Thirteen were published as complete manuscripts and four as abstracts (Table). Assessment of outcome without knowledge of colonization status was described in three studies.1, 3, 12 In general, there was less information about methods in abstracts than in full publications. Two abstracts did not separate the outcomes in those with U. urealyticum from those with M. hominis. Because of the low incidence of M. hominis colonization, patients
DISCUSSION
The performance of a metaanalysis on observational studies has been criticized13 because the allocation of exposure (in this case, U. urealyticum colonization) was not randomized. However, it is neither feasible nor ethically desirable to perform a randomized trial when determining an association with an adverse outcome. Recognizing that observational studies are more susceptible to bias than are randomized trials, it remains reasonable to pool data in summarizing the literature. To avoid bias
References (30)
- et al.
Isolation of Ureaplasma urealyticum from low birth weight infants
J PEDIATR
(1995) - et al.
Isolation of Ureaplasma urealyticum from low birth weight infants
J PEDIATR
(1995) - et al.
Isolation of Ureaplasma urealyticum from low birth weight infants
J PEDIATR
(1995) - et al.
A method for assessing the quality of a randomized control trial
Controlled Clin Trials
(1981) - et al.
Publication bias in randomized control trials
Controlled Clin Trials
(1987) - et al.
Frequency and significance of isolation of Ureaplasma urealyticum and Mycoplasma hominis from cerebrospinal fluid and tracheal specimens from low birth weight infants
J PEDIATR
(1994) - et al.
Association of Ureaplasma urealyticum infection of the lower respiratory tract with chronic lung disease and death in very-low-birth-weight infants
Lancet
(1988) - et al.
Ureaplasma urealyticum colonization and chronic lung disease in low birth weight infants
Pediatr Infect Dis J
(1988) - et al.
The role of Ureaplasma urealyticum and other pathogens in the development of chronic lung disease of prematurity
Pediatr Infect Dis J
(1988) - et al.
Ureaplasma urealyticum and chronic lung disease of prematurity: critical appraisal of the literature on causation
Clin Infect Dis
(1993)
Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials
JAMA
Ureaplasma urealyticum in a neonatal intensive care population
J Paediatr Child Health
New prospective studies of the association of Ureaplasma urealyticum (U. urea) colonization and chronic lung disease
Clin Infect Dis
Point/counterpoint: meta-analysis of observational studies-meta-analysis/shmeta-analysis
Am J Epidemiol
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2015, Clinics in PerinatologyCitation Excerpt :In older children and adults, macrolides have been shown to be beneficial in inflammatory lung diseases, such as cystic fibrosis and chronic obstructive pulmonary disease.21,22 In preterm infants, infection with Ureaplasma species may play a role in the development of BPD.23,24 Following this observation, investigators began to evaluate whether macrolides would benefit infants at risk for BPD.
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From the Division of Infectious Disease and Clinical Epidemiology Unit, Hospital for Sick Children, the Department of Newborn and Developmental Pediatrics and Clinical Epidemiology Unit, Women's College Hospital, and the Department of Pediatrics and Clinical Epidemiology and Health Care Research Program, University of Toronto, Toronto, Ontario, Canada
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Reprint requests: Elaine E. L. Wang, MD, CM, Clinical Epidemiology Unit, Hospital for Sick Children, 555 University Ave., Toronto, Ontario M5G 1X8, Canada.
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0022-3476/95/$5.00 + 0 9/23/66828