怀孕中的和生殖结果:系统审查和元分析
Luz Viale1, John Allotey2, Fiona Cheong-See2
1Centro Rosarino de Estudios Perinatales, Rosario, Argentina.
Lancet (London, England)
|August 31, 2015
概括
患有的妇女在怀孕期间面临更高的流产,出血,高血压疾病和早产的风险. 抗药物暴露进一步导致这些不良妊娠结果.
科学领域:
- 产科和妇科
- 神经学
- 药理学
背景情况:
- 对于患有的孕妇来说,产前护理不一致.
- 量化与和抗药物相关的风险对于指导治疗至关重要.
- 这项研究系统地审查了和AED暴露对怀孕结果的影响.
研究的目的:
- 研究和不良生殖结果之间的关联.
- 评估抗药物暴露对这些结果的影响.
- 提供证据来改善患有的孕妇的咨询.
主要方法:
- 观察性研究的系统审查和元分析 (1990-2015).
- 搜索了多个数据库 (MEDLINE,Embase,Cochrane,AMED,CINAHL) 没有语言或地区限制.
- 使用纽卡斯尔-太华尺度评估偏差风险;使用随机效应元分析总结关联为几率比率 (OR) 和95%置信区间 (CI).
主要成果:
- 包括38项研究,包括2,837,325例怀孕.
- 患有的妇女发生自发流产 (OR 1.54),产前出血 (OR 1. 49),产后出血 (OR 1. 29),高血压障碍 (OR 1. 37),引产 (OR 1. 67),剖腹产 (OR 1. 40),早产 (OR 1.16) 和胎儿生长限制 (OR 1.26) 的几率增加.
- 在早产,妊娠期糖尿病,胎儿死亡或新生儿集中治疗室入院方面没有发现显著差异.
结论:
- 在,抗药物暴露和不良妊娠结果之间存在显著的关联.
- 医疗保健提供者在为患有的孕妇提供咨询时应考虑这种增加的风险.
- 这些证据支持针对患者的产前护理策略.
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