摘要
目的通过Meta分析探讨未足月胎膜早破的危险因素,为预防及推迟胎膜早破的孕周提供理论依据。方法通过计算机检索中国知网(CNKI)、维普(VIP)、万方(WangFang Data)、中国生物医学文献服务系统、PubMed、The Cochrane Library、Web of Science、Embase数据库,自建库以来有关未足月胎膜早破及其危险因素相关的研究,根据纳入、排除标准对文献进行数据提取并应用Rev Man 5.3软件进行Meta分析。结果最终纳入25个临床研究,共提取13个相关影响因素,Meta分析结果显示,生殖道感染(OR=2.58,95%CI:2.00~3.32,P<0.01)、胎位异常(OR=2.28,95%CI:1.84~2.84,P<0.01)、人流史(≥2次)(OR=1.95,95%CI:1.70~2.24,P<0.01)、双胎或多胎(OR=6.98,95%CI:4.01~12.14,P<0.01)、腹压升高或羊水增多(OR=3.50,95%CI:1.73~7.06,P=0.0005)、早产史或未足月胎膜早破史(OR=3.43,95%CI:2.27~5.19,P<0.01)、妊娠合并症或并发症(糖尿病、心脏病、GDM或子痫)(OR=1.72,95%CI:1.30~2.29,P=0.0002)、产前阴道出血史(OR=4.21,95%CI:2.30~7.70,P<0.01)、体质量增加少或BMI≥27 kg/m;(OR=2.38,95%CI:1.71~3.32,P<0.01)、宫颈机能不全(OR=16.39,95%CI:4.35~61.78,P<0.01)、吸烟(OR=2.01,95%CI:1.45~2.79,P<0.01)、妊娠合并贫血(OR=3.29,95%CI:1.83~5.94,P<0.01)、孕次(OR=2.43,95%CI:1.91~3.09,P<0.01)是未足月胎膜早破发生的危险因素。结论加强避孕知识科普、减少人流次数、指导孕妇定期产检、注重孕期营养、控制孕期体质量、合理运动、鼓励孕妇戒烟等可以预防未足月胎膜早破的发生。
Objective To identify the risk factors associated with preterm premature rupture of membranes(PPROM)by performing a Meta analysis,and to provide a theoretical evidence for preventing and delaying the gestational week of premature rupture of membranes.Methods Databases as CNKI,VIP,Wan Fang Data,CBM,PubMed,the Cochrane library,Web of Science and EMbase were electronically searched to retrieve all studies related to PPROM and its risk factors.According to the inclusion and exclusion criteria,data were extracted from the literatures and Rev Man 5.3 software was used for meta-analysis.Results 25 clinical studies were included in the analysis,and a total of 13 risk factors associated with PPROM were identified.Meta analysis showed that reproductive tract infection(OR=2.58,95%CI:2.00-3.32,P<0.01),abnormal fetal position(OR=2.28,95%CI:1.84-2.84,P<0.01),history of abortion(≥2 times)(OR=1.95,95%CI:1.70-2.24,P<0.01),twins or multiplets(OR=6.98,95%CI:4.01-12.14,P<0.01),elevated abdominal pressure or increased amniotic fluid(OR=3.50,95%CI:1.73-7.06,P=0.0005),history of preterm birth or PPROM(OR=3.43,95%CI:2.27-5.19,P<0.01),pregnancy complications(diabetes,heart disease,GDM or eclampsia)(OR=1.72,95%CI:1.30-2.29,P=0.0002),history of prenatal vaginal bleeding(OR=4.21,95%CI:2.30-7.70,P<0.01),low weight gain or BMI≥27 kg/m2(OR=2.38,95%CI:1.71-3.32,P<0.01),cervical insufficiency(OR=16.39,95%CI:4.35-61.78,P<0.01),smoking(OR=2.01,95%CI:1.45-2.79,P<0.01),pregnancy with anemia(OR=3.29,95%CI:1.83-5.94,P<0.01),gravidity(OR=2.43,95%CI:1.91-3.09,P<0.01)were major risk factors associated with PPROM.Conclusions Multiple risk factors are associated with PPROM.Therefore,targeted interventions should be proposed,including enhancing the knowledge of contraception,reducing the frequency of abortion,guiding pregnant women for regular check-ups,supplementing nutrition and controlling weight gain during pregnancy,exercising,quitting smoking in order to prevent PPROM.
作者
刘姣
赵明阳
梁弘
胡斌华
方刚
LIU Jiao;ZHAO Ming-yang;LIANG Hong;HU Bin-hua;FANG Gang(Guangxi Key Laboratory of Applied Basic Research of Zhuang Medicine,Guangxi University of Traditional Chinese Medicine,Nanning,Guangxi Zhuang Autonomous Region 530001,China)
出处
《中国预防医学杂志》
CAS
CSCD
北大核心
2022年第1期44-50,共7页
Chinese Preventive Medicine
基金
广西壮族自治区卫生健康委重点培育实验室项目(桂卫科教发[2020]17号)
广西医学高层次骨干人才培养“139”计划资助项目(桂卫科教发[2020]15号)
广西中医药大学“岐黄工程”高层次人才团队培育项目(2021003)。
关键词
未足月胎膜早破
危险因素
META分析
Preterm premature rupture of membranes
Risk factors
Meta analysis
