孕妇和新生儿的结局是否与单独或双胞胎怀孕受高血压疾病影响有所不同? 一个系统的审查和元分析
Qingqing Shen1, Qingqing Huang1
1Maternity ward, Hangzhou Women's Hospital, Hangzhou, Zhejiang Province, China.
概括
双胞胎怀孕与高血压妊娠障碍 (HDP) 显示出高风险的早产,剖腹产和新生儿死亡相比单子. 然而,像Apgar分数和NICU入院等结果是相似的.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 新生儿周产医学 新生儿周产医学
背景情况:
- 妊娠高血压障碍 (HDP) 是影响母亲和胎儿健康的常见并发症.
- 将单子与双胞胎怀孕的结果与HDP进行比较对于临床管理至关重要.
- 现有的文献可能无法完全阐明多胎妊娠中与HDP相关的差异性风险.
研究的目的:
- 进行对单子和双胞胎怀孕中孕妇和新生儿结局的比较分析,这些怀孕过程因妊娠高血压障碍 (HDP) 而复杂.
主要方法:
- 在包括PubMed,Scopus和Web of Science在内的主要数据库中进行了系统的文献搜索,截至2025年5月15日.
- 包括的研究重点是对单胎和双胎怀孕中受HDP影响的比较结果.
- 分析了来自13项选定的研究的数据,以评估各种孕产妇和新生儿终点.
主要成果:
- 与单子妊娠相比,双胞胎怀孕中使用HDP的早产和剖腹产风险明显更高.
- 虽然对于妊娠年龄来说小 (SGA) 在双胞胎中更为频繁,但在对子宫的亚组分析时,这种关联减少了.
- 在5分钟的阿帕尔分数,呼吸困难或新生儿重症监护室入院方面没有发现显著差异;然而,双胞胎的新生儿死亡风险较高.
结论:
- 与单独怀孕相比,双胞胎怀孕的HDP并发症与早产,剖腹产,SGA和新生儿死亡率的风险增加有关.
- 研究结果表明,双胞胎怀孕的孕产前对SGA具有潜在的保护作用,尽管由于证据有限和混因素,这需要谨慎解释.
- 目前的证据基础因缺乏对混因素的调整而受到限制,这凸显了进一步严格研究的必要性.
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