妊娠中のと生殖に関する結果:体系的なレビューとメタ解析
Luz Viale1, John Allotey2, Fiona Cheong-See2
1Centro Rosarino de Estudios Perinatales, Rosario, Argentina.
Lancet (London, England)
|August 31, 2015
まとめ
妊娠中に妊娠中絶,出血,高血圧障害,早産のリスクが高くなります. 抗薬への曝露は,これらの不良妊娠結果にさらに寄与します.
科学分野:
- 産婦人科
- 神経学
- 薬理学について
背景:
- 妊婦の産前治療は一貫していない.
- エピレプシーと抗エピレプシー薬 (AED) に関するリスクを定量化することは,管理の指針として極めて重要です.
- この研究では,エピレプシーとAEDの曝露が妊娠の結果に及ぼす影響を体系的に検討しています.
研究 の 目的:
- エピレプシーと不良生殖結果との関連を調査する.
- これらの結果に対する抗薬の影響を評価する.
- 妊娠中の女性へのカウンセリングの改善のための証拠を提供すること.
主な方法:
- 観察研究 (1990年−2015年) の体系的レビューとメタ解析
- 複数のデータベース (MEDLINE,Embase,Cochrane,AMED,CINAHL) で検索した. 言語や地域による制限はなかった.
- ニューカッスル・オタワスケールを用いてバイアスのリスクを評価し,ランダム効果メタアナリシスを用いて95%信頼区間 (CI) の確率比 (OR) として関連を要約した.
主要な成果:
- 2,837,325人の妊娠を対象とした38件の研究が含まれています.
- 妊娠中絶 (OR1. 54),出産前出血 (OR1. 49),出産後の出血 (OR1. 29),高血圧障害 (OR1. 37),出産誘導 (OR1. 67),帝王切開 (OR1. 40),早産 (OR1.16) と胎児の成長制限 (OR1.26) が増加した.
- 早期の早産,妊娠中の糖尿病,胎児死亡,またはNICU入院の有意な違いは観察されなかった.
結論:
- エピレプシー,抗エピレプシー薬への曝露,および不良な妊娠結果との間に重要な関連性があります.
- 保健医療提供者は,この増加したリスクを考慮して,妊娠中の女性にを相談する必要があります.
- この証拠は を患う女性向けの 産前ケア戦略を裏付けています
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