打破习惯:怀孕相关的戒烟随机对照试验的系统审查和元分析
Omnia S Elseifi1, Faten Ezzelarab Younis1, Iman M Mirza1
1Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk 47913, Saudi Arabia.
认知行为咨询和经济激励措施显著提高了孕妇吸烟戒断率. 这些干预措施还导致胎儿出生体重的改善,突出了它们在改善妊娠结果方面的有效性.
科学领域:
- 公共卫生 公共卫生
- 产科 产科 产科 产科 产科
- 行为科学 行为科学
背景情况:
- 怀孕期间吸烟对孕产妇和胎儿的健康构成重大风险.
- 有效的戒烟策略对于改善妊娠结果至关重要.
- 现有的研究需要对各种戒烟计划进行全面评估.
研究的目的:
- 评估戒烟计划对孕妇戒烟率的影响.
- 确定这些干预措施对关键妊娠结果的影响,特别是胎儿出生体重.
- 使用元分析合成随机对照试验 (RCT) 的证据.
主要方法:
- 对21项涉及8149名孕妇吸烟者的RCT进行了元分析,这些RCT遵循了PRISMA标准.
- 使用审查经理 (RevMan 5.4) 和风险比率 (RR) 的计算进行了聚合效应估计.
- 使用GRADE方法评估证据确定性,通过I2统计和敏感性分析评估异质性,使用Egger的测试和漏斗图表评估出版偏差.
主要成果:
- 认知行为咨询 (RR: 1.14) 和财务激励 (RR: 2.37) 显著增加了戒烟率.
- 对于其他行为方法或药物治疗,没有发现戒断率的显著差异.
- 干预组妇女产生的婴儿出生时体重明显更高 (MD = 94.73g).
结论:
- 认知行为咨询和经济激励是孕妇戒烟的有效策略.
- 这些干预措施对妊娠结果产生积极影响,特别是增加胎儿出生体重.
- 进一步的研究可能会探索结合或量身定制的方法,以提高疗效.
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