Reevaluating the association between chorioamnionitis and cerebellar hemorrhage: A systematic review and meta-analysis.

Chorioamnionitis is a recognized risk factor for intraventricular hemorrhage and white matter injury in preterm infants. However, its association with cerebellar hemorrhage (CBH) remains controversial with conflicting evidence in the literature. To clarify this relationship, we conducted a systematic review and meta-analysis examining the association between chorioamnionitis and CBH. PubMed/MEDLINE, EMBASE, and the Cochrane Library were searched for articles from their inception to December 2024 by two independent reviewers. Studies that compared infants with CBH to those without, while also reporting maternal history of chorioamnionitis, were included in the analysis. Studies without adequate information about the control group were excluded. The Newcastle-Ottawa scale was used to assess the risk of bias in the studies included. A random-effects model was used to calculate the pooled odds ratio and 95% confidence interval. Out of 261 studies screened, 7 studies were included, reaching a total of 1216 infants with 331 with documented chorioamnionitis. Meta-analysis findings demonstrated that chorioamnionitis exposure was significantly associated with an increased risk of CBH (OR 1.71, 95% CI: 1.25-2.35). Notably, prior meta-analyses did not establish a significant link between chorioamnionitis and CBH. Findings suggest that more recent studies may be detecting an association, warranting further investigation into the potential pathophysiological mechanisms and confounding factors influencing this relationship. Systematic Review Registration: PROSPERO identifier: CRD42024626144.