生殖道感染与早产相关性及人群归因危险度的Meta分析

Meta-analysis of Population Attributable Risk and the Relationship between Reproductive Tract Infection and Premature Birth

目的 系统评价生殖道感染与早产的相关性及人群归因危险度。方法 计算机检索PubMed、The Cochrane Library、Web of Science(WOS)、CBM、知网、万方和维普,搜集我国大陆地区10 a间(2007年1月至2017年12月)孕妇早产相关危险因素的病例-对照研究、队列研究和横断面研究,由2名研究者独立进行文献筛选、资料提取并评价纳入研究的偏倚风险后,采用Stata软件进行综合分析,计算生殖道感染与早产的OR值及其95%CI,并结合总人群暴露率,计算生殖道感染的人群归因危险度。结果 共纳入10个研究,早产例数共2 525例,早产组中生殖道感染的例数总622例,感染率为24.63%;足月组总例数为18 944例,足月组中生殖道感染例数共1 889例,感染率为9.97%;经Meta分析结果显示:生殖道感染与早产有相关性,其差异有统计学意义[OR=2.037 95% CI: 1.490-2.784,Z=4.46];综合人群归因危险度为20.94%。结论 生殖道感染与早产关联性较强,且在人群中暴露率较高,孕妇应注意个人卫生并积极采取治疗,预防早产的发生。

Objective To study the correlation between genital tract infection and premature delivery and population attribution risk with the method of systematic review. Methods By retrieving data with computers in PubMed,The Cochrane Library,Web of Science(WOS),CBM,CNKI,Wanfang and Vip databases, case-control studies, cohort and cross-sectional studies which were related to premature delivery of pregnant women in China were collected. The search period was from 2007 to 2017. Then ,the literature was screened independently by two researchers. After the data were extracted and evaluated,the OR value and 95% CI of genital tract infection and premature delivery were calculated by Stata software. At the same time, the attributable risk percentage of genital tract infection was calculated according to the exposure rate of the total population. Results A total of 10 studies were included. The total number of cases of premature delivery was 2 525,and the number of cases of genital tract infection in the preterm group was 622,the infection rate was 24.63%. The total number of cases in the group of term delivery was 18 944, and the number of cases of genital tract infection in the group of term delivery was 1 889,the infection rate was 9.97%. The results of Meta-analysis showed that there was a correlation between genital tract infection and premature delivery, and the difference was statistically significant [OR=2.037 95% CI: 1.490 2.784, Z 4.46], and the combined attributable risk was 20.94%. Conclusion Genital tract infection is closely related to premature delivery,and the exposure rate is high in the population. Pregnant women should pay attention to personal hygiene and take active treatment to prevent the occurrence of premature delivery.