子宫内膜异位症与早产相关性的meta分析

Amaeta-analysis of the Association between endometriosis and preterm birth

目的 通过meta分析来评价子宫内膜异位症和早产的相关性。方法计算机检索中国知网,中国生物医学文献数据库,万方数据库,维普数据库,Pub Med,EMBASE,Web of Science,MEDLINE和Cochrane Library数据库,搜集子宫内膜异位症和早产相关性的相关文献,文献研究类型为队列研究,检索时限均为建库以来至2021年9月3日。提取纳入文献的相关数据及对纳入文献进行质量评估后,使用Review Manager 5.4和Stata 12.0进行meta分析。并使用漏斗图和egger检验对发表偏倚进行估计。结果 共纳入了8篇文献,纳入文献的研究共包含10 817人(其中子宫内膜异位症组2 266人,对照组8 551人)。对纳入文献进行meta分析,发现患子宫内膜异位症的妇女发生早产的风险更高(RR=1.49,95%CI:1.28~1.73)。在自然受孕的妇女中,患子宫内膜异位症的妇女与正常妇女相比,发生早产的风险增加1.28倍(RR=2.28,95%CI:1.51~3.45);在人工辅助生殖受孕的妇女中,患子宫内膜异位症的妇女与正常妇女相比,发生早产的风险增加0.38倍(RR=1.38,95%CI:1.18~1.62)。对纳入的文献进行发表偏倚估计,漏斗图中各文献基本在中心线左右对称分布,egger检验无统计学意义(t=-0.44,P=0.676),提示存在发表偏倚的可能性较小。结论 无论通过何种方式受孕,患有子宫内膜异位症的妇女比正常妇女发生早产的风险均更高。这提示我们需要对妊娠期的子宫内膜异位症妇女采取更多的临床护理措施,预防早产的发生,以减少早产对妇女和胎儿的健康损害。

Objective To evaluate the association between endometriosis and preterm birth using meta-analysis. Methods CNKI, Chinese biomedical literature database, Wanfang database, VIP database, Pub Med, EMBASE, Web of Science, MEDLINE, and Cochrane Library databases were retrieved electronically to collect relevant literature related to endometriosis and premature delivery. The type of literature study was a cohort study. The search time limit was from database establishment to September 3 2021. After extraction of relevant data from the included articles and quality assessment of the included articles, meta-analysis was performed using Review Manager 5.4 and Stata 12.0. Publication bias was also estimated using funnel plots and Egger tests. Results A total of 8 articles were included, and the studies included in the articles comprised a total of 10 817 Participants(2 266 in the endometriosis group and 8 551 in the control group). A meta-analysis of the included literature found that women with endometriosis had a higher risk of preterm birth(RR=1.49, 95% CI:1.28 to 1.73). In women who conceived naturally, women with endometriosis had a 1.28-fold increased risk of preterm birth compared with normal women(RR=2.28, 95% CI:1.51 to 3.45). in women who conceived with artificial assisted impregnation, women with endometriosis had a 0.38-fold increased risk of preterm birth compared with normal women(RR=1.38, 95% CI:1.18 to 1.62). Publication bias was estimated for the included articles, and each article in the funnel plot was fundamentally symmetrically distributed around the center line, and the Egger test was not statistically significant(t=-0.44, P=0.676), suggesting that there was a small possibility of publication bias. Conclusion Women with endometriosis have a higher risk of premature delivery than women without it regardless of the way of conception. This suggests that we need to take more clinical care measures for women with endometriosis during pregnancy to prevent the occurrence of premature delivery to reduce the health damage of premature delivery to women and fetuses.