糖尿病组产前护理:系统审查和元分析
Ebony B Carter1, Sydney M Thayer, Rachel Paul
1Division of Maternal Fetal Medicine and the Division of Clinical Research, Department of Obstetrics and Gynecology, and the Becker Library, Washington University School of Medicine in St. Louis, St. Louis, Missouri; the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC; the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland Ohio; Harborview OB/GYN Generalists, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington; and the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
与个人护理相比,糖尿病组产前护理显示出类似的早产和妊娠年龄 (LGA) 率较大. 然而,小组护理增加了产后长效可逆避孕药 (LARC) 的摄入量,以及产后口服葡萄糖耐受性测试 (OGTT) 对于妊娠糖尿病患者的完成.
科学领域:
- 孕产妇健康 孕产妇健康
- 怀孕期间糖尿病 在怀孕期间糖尿病
- 证据综合 证据综合
背景情况:
- 怀孕期间的糖尿病,包括2型糖尿病和妊娠期糖尿病 (GDM),需要专门的产前护理.
- 团体产前护理模式正在成为传统个人护理的替代品,但它们对关键妊娠结果的影响需要评估.
研究的目的:
- 为了比较糖尿病组产前护理与个人糖尿病产前护理的有效性.
- 评估对早产率和妊娠年龄大 (LGA) 的影响.
- 评估二次结果,包括产后避孕和葡萄糖耐受性测试.
主要方法:
- 随机对照试验 (RCT) 和观察性研究的系统审查和元分析.
- 在多个电子数据库 (Ovid Medline,Embase.com,Scopus,Cochrane,ClinicalTrials.gov) 进行了搜索.
- 聚合相对风险 (RRs) 和加权平均差异计算了初级和二级结果.
主要成果:
- 分析了包括1701名患者在内的8项研究 (3项RCT,5项观察性).
- 与个人护理相比,糖尿病组产前护理显示出类似的早产率 (RR 0.77) 和LGA (RR 0.93).
- 小组护理显著增加了产后长效可逆避孕 (LARC) 的吸收 (RR 1.44) 和,对于GDM患者,产后口服葡萄糖耐受性测试 (OGTT) 的完成 (RR 1.58).
结论:
- 糖尿病组产前护理是个人护理的可行替代方案,产生的早产和LGA的比较率.
- 团体产前护理提高了产后LARC的吸收率,并改善了GDM患者的产后OGTT完成率.
- 这些发现支持集体产前护理模型的整合,以管理妊娠糖尿病.
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