不同程度妊娠高血压与围生期因素的相关性Meta分析

Meta-analysis of the correlation between different degrees of pregnancy-induced hypertension and perinatal factors

目的采用Meta分析不同程度妊娠高血压疾病与围生期因素的相关性。方法通过Medline、Pubmed、科学引文检索、Embase、Springer、Cochrane、万方、维普和CNKI等数据库,检索2006年1月至2021年1月相关文献,文献研究类型为队列研究或病例对照研究(case-control study,CCS),语种为英文和中文。根据制定的纳入和排除标准进行文献筛选,筛选出符合要求的文献,采用Meta分析对这些文献进行系统综述分析,以比值比(oddsratio,OR)作为影响计数资料因素的效应值,以OR、95%可信区间(confidence interval,CI)表示各效应量区间范围。结果最终符合纳入和排除标准的文献有20篇,其中中文文献4篇,英文文献16篇。Meta分析后,发现:(1)初次产检时BMI≥35 kg/m^(2):OR值为2.86,95%CI(2.58,3.16),P<0.001;(2)孕妇年龄≥40岁:OR值为1.71,95%CI(1.49,2.28),P<0.001;(3)孕妇家族有高血压史:OR值为4.95,95%CI(4.39,5.89),P<0.001;(4)孕妇有子痫前期疾病史:OR值为8.87,95%CI(6.79,11.80),P<0.001;(5)孕妇有慢性高血压病史:OR值为5.18,95%CI(3.76,6.58),P<0.001;(6)孕妇营养缺乏:OR值为3.23,95%CI(2.48,4.21),P<0.001;(7)首次受孕:OR值为1.42,95%CI(1.36,1.64),P<0.001;(8)心理社会应激反应强烈:OR值为3.18,95%CI(2.52,3.88),P<0.001;(9)文化程度低下:OR值为0.56,95%CI(0.43,0.75),P<0.001;(10)患有糖尿病等基础代谢性疾病:OR值为2.68,95%CI(1.87,3.85),P<0.001。结论本研究通过Meta分析探讨不同程度妊娠高血压疾病与围生期因素的相关性,为将来围生期保健、预防或者临床治疗提供理论基础。

Objective The correlation between different degrees of pregnancy-induced hypertension and perinatal factors was analyzed by Meta. Methods Through Medline, PubMed, Scientific Citation Search, Embase, Springer, Cochrane,Wanfang, VIP, CNKI and other databases, the literature were searched from January 2006 to January 2021. The type of literature research was cohort study or case-control study(CCS). Study, CCS, and the languages were English and Chinese. According to the established inclusion and exclusion criteria, the literature that met the requirements is screened. Meta-analysis was used to conduct a systematic review and analysis of these literatures. The odds ratio(OR) was as the effect value of the factors affecting the enumeration data. The 95% confidence interval(CI) represent the range of each effect size interval. Results There were 20 articles that met the inclusion and exclusion criteria, including 4 Chinese articles and 16 English articles.After the Meta-analysis, the results were as follows:(1) BMI was ≥35 kg/m^(2) at the initial check-up: OR value was 2.86,95%CI(2.58, 3.16), P<0.001;(2) Pregnant women’s age was ≥40 years old: OR value is 1.71, 95%CI(1.49, 2.28), P<0.001;(3) Pregnant women with a family history of hypertension: OR value was 4.95, 95%CI(4.39, 5.89), P< 0.001;(4) Pregnant women had a history of preeclampsia: OR value 8.87, 95%CI(6.79, 11.80), P<0.001;(5) Pregnant women with a history of chronic hypertension: OR value was 5.18, 95%CI(3.76, 6.58), P<0.001;(6) Maternal nutrition deficiency: OR value was 3.23,95%CI(2.48, 4.21), P<0.001;(7) First conception: OR value was 1.42, 95%CI(1.36, 1.64), P<0.001;(8) Psychosocial stress response is strong: OR value was 3.18, 95%CI(2.52, 3.88), P<0.001;(9) Low education level: OR value was 0.56, 95%CI(0.43, 0.75), P<0.001;(10) Diabetes and other basic metabolic diseases: OR value was 2.68, 95%CI(1.87, 3.85), P<0.001.Conclusion This study explored the correlation between different degrees of hypertension in pregnancy and perinatal factors through Meta analysis, and provided a theoretical basis for future perinatal care, prevention or clinical treatment.