不良妊娠结局危险因素的Meta分析

Meta-analysis on risk factors of adverse pregnancy outcome

目的:利用Meta分析方法探讨影响我国妇女不良妊娠结局的危险因素,为制定预防措施提供依据。方法:通过文献检索收集不良妊娠结局病例对照研究的相关文献,应用严格的纳入和剔除标准进行筛检,采用随机效应模型和固定效应模型通过Review Manager4.2软件进行分析评价。结果:纳入文献21篇,累计病例3298例,对照27886例。解脲脲原体感染合并OR值为5.57(1.66,18.63);沙眼衣原体感染合并OR值为4.15(1.95,8.87);多胎妊娠合并OR值为6.42(2.06,19.99);妊娠期高血压疾病合并OR值2.87(1.68,4.91):胎位异常合并OR值为3.46(2.71,4.42);流产史合并OR值为1.15(0.91,91.45)。结论:本研究分析显示不良妊娠结局的危险因素由强到弱依次为:多胎妊娠,解脲脲原体感染,沙眼衣原体感染,胎位异常和妊娠期高血压疾病。

Objective： To explore the risk factors of adverse pregnancy outcome by me a -analysis, provide evidences for preven- tion. Methods ： Case - control studies for meta - analysis were collected by literature retrieval according to strict inclusion and exclusion cri- teria. Fixed effect model and random, effect model were applied to the analysis. The analysis was performed on Review Manager 4. 2 soft- ware. Results： 21 published papers were adopted. The cumulative cases and control cases were 3 298 and 27 886, respectively. The merged OR values and 95 % CI of the infections of UU, CT, polyembryony, hypertensive disorder complicating pregnancy, malposition and the histo- ry of abortion were 5. 57 （1.66, 18.63）,4.15 （1.95, 8.87）, 6. 42 （2.06, 19. 99）, 2. 87 （1.68, 4. 91）, 3.46 （2.71, 4.42） and 1.15 （0.91,91.45） . Conclusion： The main risk factors of adverse pregnancy outcome are polyembryony, infection of UU and CT, malpo- sition and hypertensive disorder complicating pregnancy.