妊娠期补锌对新生儿出生体重影响的meta分析

Effect of zinc supplementation during pregnancy on neonatal birth weight: a meta-analysis

目的系统评价妊娠期补锌对新生儿出生体重的影响,为妊娠期合理补锌提供循证依据。方法计算机检索CNKI、CBM、WanFang Data、PubMed、Web of Science、EMbase、The Cochrane Library、Ebsco等数据库,搜集妊娠期补锌对新生儿出生体重影响的随机对照试验(RCT),检索时限为建库至2022年5月。两位研究者独立背对背进行文献筛选,资料提取并对文献质量进行偏倚风险评估,使用RevMan 5.3软件进行meta分析。结果共10个RCT纳入研究,包括研究对象4267例。meta分析结果显示:与对照组相比,妊娠期补锌对新生儿出生体重的影响并不显著(MD=6.87,95%CI:-18.47~32.21,P=0.60)。亚组分析结果显示,锌基础水平低的人群妊娠期补锌(MD=-7.61,95%CI:-69.90~54.68,P=0.81)和锌基础水平正常人群妊娠期补锌(MD=16.83,95%CI:-28.17~61.84,P=0.46)比较,差异无统计学意义(P>0.05);妊娠期单独补充锌(MD=-3.09,95%CI:-55.19~49.00,P=0.91)和含锌的多种微量营养素联合补充(MD=20.95,95%CI:-40.95~82.36,P=0.50)比较,差异无统计学意义(P>0.05)。结论当前证据显示,妊娠期补锌对新生儿出生体重没有显著影响。因纳入文献的质量和数量有所限制,所以本结论有待更多高质量研究给予验证。

Objective To systematically evaluate the effect of zinc supplementation during pregnancy on neonatal birth weight,and to provide evidence for reasonable zinc supplementation during pregnancy.Methods Databases including CNKI,CBM,WanFang Data,Web of Science,PubMed,EMbase,Cochrane Library,Ebsco were searched to collect randomized controlled trials(RCT)on the effect of zinc supplementation during pregnancy on neonatal birth weight were to provide evidence basis for rational zinc supplementation during pregnancy from inception to May 2022.Two researchers independently conducted back-to-back literature screening,data extraction and risk assessment of literature quality bias.Meta analysis was performed by RevMan 5.3 software.Results A total of 10 RCTs were included in the study,including 4267 subjects.The results of meta analysis results showed that:compared with control group,zinc supplementation during pregnancy had no significant effect on neonatal birth weight(MD=6.87,95%CI:-18.47-32.21,P=0.60).The results of subgroup analysis showed that there was no statistically significant difference between the zinc supplemention during pregnancy in the group with low zinc basal level(MD=-7.61,95%CI:-69.90-54.68,P=0.81),and in the group with normal zinc basal level(MD=16.83,95%CI:-28.17-61.84,P=0.46)(P>0.05).And there was no statistically significant difference between the zinc supplementation alone during pregnancy(MD=-3.09,95%CI:-55.19-49.0,P=0.91)and combination of multiple micronutrients containing zinc(MD=20.95,95%CI:-40.95-82.36,P=0.50)(P>0.05).Conclusion Current evidence shows that Zinc supplementation during pregnancy had no significant effect on neonatal birth weight.Due to the limited quality and quantity of the included literature,this conclusion needs to be validated by more high-quality studies.