银屑病与不良妊娠结局相关性的Meta分析

Meta-analysis of associations between psoriasis and adverse pregnancy outcomes

目的评价银屑病与不良妊娠结局的关系。方法检索1980年1月至2018年12月在中国期刊网全文数据库、万方数据库、维普数据库、PubMed、Embase数据库、Cohrane Library数据库,筛查纳入1980年1月至2018年12月间公开发表的关于银屑病与妊娠结局之间关系的文献。使用MOOSE清单评价纳入文献质量,采用Review Manager5.3软件进行统计学分析。结果纳入1篇队列研究,4篇病例对照研究,2篇横断面研究,采用随机效应模型,检验结果显示,银屑病患者中剖宫产[OR=1.17(95%CI:1.01~1.37)]、子痫或先兆子痫[OR=1.34(95%CI:1.00~1.79)]、早产[OR=1.09(95%CI:1.00~1.19)]风险较非银屑病患者发病风险高,差异有统计学意义(P<0.05);自然流产、低出生体重、高出生体重、死胎、先天畸形、胎盘早剥、过期产、Apgar评分<7、羊水过多、羊水过少风险差异均无统计学意义。结论银屑病患者中剖宫产、子痫或先兆子痫、早产的风险较非银屑病患者发病风险高。

Objective To evaluate associations of psoriasis with adverse pregnancy outcomes.Methods Databases,including CNKI,Wanfang,VIP,PubMed,Embase and Cohrane Library databases,were searched for published articles on associations between psoriasis and adverse pregnancy outcomes between January 1980 and December 2018.Quality of included articles was assessed by using MOOSE checklist.Statistical analysis was carried out with Review Manager 5.3 software.Results One cohort study,4 case-control studies and 2 cross-sectional studies meet the inclusion criteria.After heterogeneity test,meta-analysis was carried out by using a random effect model.The risks of cesarean(OR=1.17,95%CI:1.01-1.37),eclampsia or preeclampsia(OR=1.34,95%CI:1.00-1.79)and premature birth(OR=1.09,95%CI:1.00-1.19)were significantly higher in patients with psoriasis than in individuals without psoriasis(all P<0.05).There was no significant difference between patients with psoriasis and individuals without psoriasis in the risks of spontaneous abortion,low birth weight,high birth weight,stillbirth,congenital malformation,placental abruption,overdue delivery,low Apgar score(<7),polyhydramnios and oligohydramnios.Conclusion The risks of cesarean,eclampsia or preeclampsia,and premature birth are higher in patients with psoriasis than in individuals without psoriasis.