怀孕期间母亲创伤性脑损伤后的并发症:系统性审查
Carina Heller1,2,3,4,5,6, Mathilda Kraft7, Margaret Martinez8,9
1Masonic Institute for the Developing Brain, Institute of Child Development, University of Minnesota, Minneapolis.
JAMA network open
|February 17, 2025
概括
怀孕中创伤性脑损伤 (TBI) 对孕产妇和胎儿健康的影响尚不清楚,因为证据有限且质量不佳. 需要更严格的研究来建立明确的协会和指导管理策略.
科学领域:
- 神经学 神经学
- 产科和妇科 产科和妇科
- 创伤外科 手术 创伤外科
背景情况:
- 创伤性脑损伤 (TBI) 是孕产妇发病率和死亡率的一个重要原因.
- 患有TBI的孕妇需要复杂的管理,因为生理变化和原性风险.
- 评估TBI对怀孕的影响对于临床决策至关重要.
研究的目的:
- 评估怀孕期间创伤性脑损伤对母亲和胎儿的后果.
- 审查当前对孕妇TBI的管理策略.
主要方法:
- 在PubMed,Web of Science和PsycInfo进行了系统的文献搜索.
- 包括同行评审的研究,其中包括关于TBI孕妇的孕妇和胎儿结果的原始数据.
- 排除了评论,元分析和非人类研究;遵循PRISMA指南.
主要成果:
- 审查了涉及4,112人的16篇文章,机动车祸是TBI最常见的原因.
- 母亲的结果从康复到严重损伤不等;胎儿的结果差异很大,包括死产.
- 偏差风险评估表明中等到良好的有效性,但整体证据质量差到中等.
结论:
- 由于相互矛盾的发现和有限的证据质量,怀孕期间TBI与母亲/胎儿结果之间没有确定的关联.
- 一些研究表明胎盘断裂等风险增加,但结果不确定.
- 高质量的研究和标准化的多学科管理策略对于改善结果至关重要.
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