孕期糖尿病后母亲和婴儿短期和长期结果的预测模型:系统性审查
Yasmina Al Ghadban1, Nerys M Astbury2,3, Abdallah Kurdi4
1Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.
概括
预测妊娠糖尿病 (GDM) 的不良结果至关重要. 这次审查发现,大多数GDM预测模型缺乏严格性,表明需要更好的工具来帮助母亲和婴儿的临床决策.
科学领域:
- 产科和妇科 产科和妇科
- 周围生理学 周围生理学
- 公共卫生 公共卫生
背景情况:
- 孕期糖尿病 (GDM) 影响全球7分之一的孕妇,对母亲和婴儿构成风险.
- 现有的GDM预后模型对临床影响有限.
- 本综述批判性地评估了GDM相关不良结果的预测模型.
研究的目的:
- 系统地审查和评估对不良妊娠糖尿病结果的预测模型.
- 为进一步验证和临床实用性评估确定有前途的模型.
主要方法:
- 在主要的生物医学数据库 (EMBASE,MEDLINE,Web of Science,CINAHL,CENTRAL) 进行了全面的搜索.
- 包括报告关于开发或验证对母亲或后代GDM结果的预测模型的研究.
- 在PROSPERO注册:CRD42023396697.7. 在PROSPERO注册:CRD42023396697.
主要成果:
- 在64篇文章中确定了103个开发和12个验证的模型.
- 模型预测了长期 (45%),分娩 (31%) 和怀孕 (23%) 的结果.
- 由于数据不足,验证不良或校准不充分,观察到高偏差风险 (87%);只有8个模型具有低风险.
结论:
- 对于不良GDM结果的预测模型的严格开发存在重大差距.
- 需要对现有模型进行进一步的验证和临床实用性评估.
- 需要改进风险预测工具,以提高GDM管理的临床决策.
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