剖宫产预防产后大便失禁的Meta分析

Cesarean section for the prevention of postpartum fecal incontinence:a Meta-analysis

目的系统评价剖宫产对产后大便失禁发生率的影响。方法计算机检索中国知网、中国生物医学文献(CBM)、万方、维普、PubMed、EMBASE、Web of Science、Cochrane Library中英文数据库中剖宫产对产后大便失禁发生率影响的相关文献,检索时间从建库至2022年2月2日。两名研究员独立完成文献筛选、数据提取和质量评价后,采用Review Manager 5.3软件进行Meta分析。结果共纳入8篇文献,涵盖5507例研究对象。Meta分析结果显示,剖宫产与阴道分娩在产后大便失禁发生率的差异无统计学意义[OR=0.75,95%CI(0.56,1.02),P=0.07]。结论剖宫产对比阴道分娩在预防产后大便失禁发生方面没有明显优势,不应常规将剖宫产作为预防产后大便失禁发生的一种方式,不建议在妊娠女性中为减轻大便失禁的发生而计划性选择剖宫产。

Objective To systematically evaluate the influence of cesarean section on the incidence of postpartum fecal incontinence.Methods The relevant literature of the impact of cesarean section on the postpartum fecal incontinence were searched in Chinese databases of CNKI,China Biomedical Literature Database(CBM),WanFang,VIP and English databases of PubMed,EMBASE,Web of Science,Cochrane Library.The retrieval time was from the establishment of the database to 2 February,2022.After independent literature screening,data extraction and quality evaluation by 2 researchers,Meta-analysis was performed using Review Manager 5.3 software.Results A total of 8 articles were included,enrolling 5507 subjects.Meta-analysis results showed that there was no significant difference in the incidence of postpartum fecal incontinence between cesarean section and vaginal delivery[OR=0.75,95%CI(0.56,1.02),P=0.07].Conclusion Compared with vaginal delivery,cesarean section has no obvious advantages in preventing the occurrence of postpartum fecal incontinence and should not be routinely used as a way to prevent and reduce the occurrence of postpartum fecal incontinence in pregnant women.