单、双胎妊娠并发子痫前期不良妊娠结局的荟萃分析

Adverse pregnant outcomes of singleton and twin pregnancies complicated with preeclampsia: A meta-analysis

目的探讨单、双胎妊娠并发子痫前期的孕妇与围产儿不良结局发病率差异。方法检索Pub Med、Web of Science、中国生物医学文献数据库、中国学术文献总库、万方和维普中文数据库中2000年1月至2017年12月国内外发表的关于单、双胎妊娠并发子痫前期妊娠结局的研究。采用Rev Man 5.3与Stata 12.0软件对资料进行荟萃分析,采用OR值及相应的95%CI评价不良结局与双胎妊娠并发子痫前期的相关性。结果纳入10篇文献,共692例双胎妊娠合并子痫前期,3101例单胎妊娠合并子痫前期。双胎妊娠合并子痫前期组发病率高于单胎妊娠合并子痫前期:胎盘早剥OR=2.16,95%CI为1.40~3.36;产后出血OR=2.90,95%CI为2.03~4.15;心功能衰竭OR=3.73,95%CI为2.10~6.63;肺水肿OR=2.76,95%CI为1.04~7.27;剖宫产OR=2.27,95%CI为1.58~3.26;胎膜早破OR=2.99,95%CI为1.64~5.47;早产OR=6.24,95%CI为4.16~9.38,新生儿重症监护病房转入率OR=2.33,95%CI为1.66~3.26。结论双胎妊娠合并子痫前期的不良妊娠结局包括胎盘早剥、产后出血、心功能衰竭、肺水肿、剖宫产、胎膜早破、早产和新生儿重症监护病房转入的发病率比单胎妊娠合并子痫前期高。

Objective To investigate the morbidity of perinatal and maternal outcomes in singleton and twin pregnancies complicated by preeclampsia. Methods Published studies about pregnant outcomes in singleton and twin pregnancy complicated by preeclampsia were searched and screened in Pub Med,Web of Science,Sino Med,Chinese Biological Medicine（ CNKI）,databases of Wanfang and VIP database of Chinese journal. Retrieval time from January 2000 to December 2017. The Rev Man 5. 3 and Stata 12. 0 software were used for meta-analysis. The correlation between twin pregnancy complicated with preeclampsia and adverse pregnancy outcomes were analyze by Pooled odds ratio（ OR） with 95%confidence interval（ CI）. Results There were 10 retrospective cohort studies,including 692 twin pregnancies complicated with preeclampsia and 3101 singleton pregnancies complicated with preeclampsia.Compared with the singleton pregnancies complicated with preeclampsia,adverse pregnant outcomes of twin pregnancies complicated with preeclampsia were increased,such as placental abruption（ OR = 2. 16,95%CI： 1. 40-3. 36）,postpartum hemorrhage（ OR = 2. 90,95% CI： 2. 03-4. 15）,heart failure（ OR =3. 73,95% CI： 2. 10-6. 63）,pulmonary edema（ OR = 2. 76,95% CI： 1. 04-7. 27）,cesarean delivery（ OR = 2. 27,95% CI： 1. 58-3. 26）,premature rupture of membrane（ OR = 2. 99,95% CI： 1. 64-5. 47）,preterm delivery（ OR = 6. 24,95% CI： 4. 16-9. 38）,the rates of newborn admitted to intensive care unit（ OR = 2. 33,95% CI： 1. 66-3. 26）. Conclusion Compared to the singleton pregnancies complicated with preeclampsia,twin pregnancies complicated with preeclampsia increased the morbidity of placental abruption, postpartum hemorrhage, heart failure, pulmonary edema, cesarean delivery,premature rupture of membrane,preterm and the rates of newborn admitted to intensive care unit.