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重新评估细菌性阴道炎和早产之间的关联:系统性审查和元分析
Sawsan Hadhoum1, Damien Subtil2, Julien Labreuche3
1Univ. Lille, CHU Lille, Hôpital Jeanne de Flandre, Pôle Femme Mère Nouveau-né, F-59000 Lille, France.
Journal of gynecology obstetrics and human reproduction
|October 23, 2024
概括
这一元分析证实细菌性阴道炎 (BV) 与早产有关,尽管这种关联比以前认为的要弱. 这一发现可能解释了为什么在怀孕期间治疗BV并没有降低早产率.
科学领域:
- 生殖健康 生殖健康
- 微生物学 微生物学
- 产科 产科 产科 产科 产科
背景情况:
- 几十年来,细菌性阴道炎 (BV) 和早产之间的关联一直在争论.
- 之前的研究质疑这种联系的原因是,怀孕期间对BV的抗生素治疗并没有降低早产风险.
研究的目的:
- 通过全面的文献审查,重新评估细菌性阴道炎和早产之间的联系.
- 综合使用元分析对BV早产相关现有证据.
主要方法:
- 在PubMed和Web of Science数据库中的系统文献搜索,截至2020年11月.
- 纳入标准侧重于在无症状孕妇中将BV (通过努根特,阿姆塞尔或斯皮格尔标准诊断) 与早产 (<37,<35,或<32周) 相关的研究.
- 数据提取和分析考虑了地理区域,诊断方法,研究期和研究质量 (纽卡斯尔-太华得分).
主要成果:
- 总共分析了28项涉及50466名参与者的研究.
- 证实了细菌性阴道炎和早产之间存在显著的关联,整体几率比 (OR) 为1.60 (95% CI,1.36-1.89).
- 观察到高异质性 (I2=67%),但高风险在各种子组和研究质量指标中保持一致.
结论:
- 分析再次证实了细菌性阴道炎和早产之间的联系.
- 确定的相关性明显低于以前在文献中报道的相关性.
- 这一修订后的理解可能会阐明当前BV治疗在减轻早产风险方面的无效性背后的原因.
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