在早产婴儿中发生支气管肺功能障碍的危险因素:系统性审查和元分析
Ping Xiong1, Lei Li1, Zhangbin Yu2
1Department of Neonatology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China.
PeerJ
|October 15, 2025
概括
这项元分析确定了早产婴儿中支气管肺功能障碍症 (BPD) 的关键风险因素. 胆膜炎,膜的过早破裂和妊娠的高血压疾病是重要的孕产妇风险因素,以及较低的妊娠年龄和男性性别.
科学领域:
- 新生儿科学 新生儿科学
- 儿科肺病学 儿科肺病学
- 围产儿医学 围产儿医学
背景情况:
- 支气管肺功能障碍 (BPD) 是早产婴儿中最常见的呼吸系统疾病.
- 过早出生婴儿的生存率增加导致BPD病例的增加,这对社会构成重大挑战.
- BPD的多因素病变包括遗传和环境影响,在之前的风险因素研究中发现的结果不一致.
研究的目的:
- 进行元分析,以确定与支气管肺功能障碍 (BPD) 发展相关的显著风险因素.
- 巩固现有关于BPD风险因素的证据,以更好地了解其病因.
- 为BPD预防和管理提供临床实践和未来研究方向的信息.
主要方法:
- 在PubMed,Embase,Cochrane图书馆和Web of Science数据库中进行了全面的文献搜索.
- 调查BPD风险因素的病例控制和队列研究被纳入了元分析.
- 从23项涉及14729例BPD病例和19101例对照的研究中获得的数据,使用Review Manager和Stata进行了分析.
主要成果:
- 胆膜炎 (OR=1.52),膜的过早破裂 (OR=1.42),以及妊娠的高血压疾病 (OR=2.73) 是重要的孕产妇风险因素.
- 较低的妊娠年龄 (MD=-1.86),男性性别 (OR=1.41) 和较小的妊娠年龄 (OR=3.14) 被确定为重要的婴儿风险因素.
- 机械通风 (MD=16.55),氧气输送 (MD=50.91),输血 (OR=1.38),大动脉通道 (OR=1.75),败血症 (OR=1.88),呼吸困扰综合征 (OR=6.37) 也是显著的危险因素.
结论:
- 严重的BPD风险因素包括胆膜炎,膜的过早破裂,妊娠的高血压疾病,较低的妊娠年龄,男性性别,SGA,机械通风,氧气管理,输血,PDA,败血症和RDS.
- 这些已识别的风险因素对预测BPD病变发生具有潜在的临床意义.
- 这些发现强调了母亲和婴儿因素以及医疗干预在BPD发展中的复杂相互作用.
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