The fetal inflammation response syndrome and adverse neonatal outcomes: a meta-analysis

Background: The clinical performance of fetal inflammatory response syndrome (FIRS) is often atypical. The aim of this meta-analysis is to investigate whether FIRS is associated with adverse neonatal outcomes. Methods: PubMed, Embase, and Cochrane Library were used in this study. The adverse neonatal outcomes data including neonatal early-onset sepsis (EOS), bronchopulmonary dysplasia (BPD), periventricular leukomalacia (PVL), intraventricular hemorrhage (IVH), respiratory distress syndrome (RDS), and neonatal death were collected to make analysis. Results: A total of 10 articles (1116 patients) were included in this study. Compared to the non-FIRS group, the FIRS group was associated with higher incidence of adverse neonatal outcomes, such as EOS (RR = 3.10, 95% CI: 1.26, 7.65; p =.014), BPD (RR = 5.93, 95% CI = 4.35, 8,08; p  < .001), IVH (RR = 4.89, 95% CI = 2.96, 8.08; p  < .001), PVL (RR = 3.32, 95% CI: 1.73, 6.40; p  < .001), RDS (2.35, 95% CI = 1.67, 3.31; p  < .001), and the neonatal death (RR = 7.04, 95% CI: 3.34, 14.85; p  < .001). Conclusions: The FIRS is associated with higher incidence of adverse neonatal outcomes, and is a risk factor of severe neonatal morbidity or death.