新生儿先天性动脉导管未闭与新生儿母亲糖尿病相关性的Meta分析  

Correlation between neonatal patent ductus arteriosus and infants of diabetic mothers:a Meta-analysis

作　　者：王瑞红 左健[1] 孙子兰 徐宝玲 郭红[1] Wang Ruihong;Zuo Jian;Sun Zilan;Xu Baoling;Guo Hong(Department of Cardiovascular Surgery,Xijing Hospital,Air Force Medical University of PLA,Xi'an 710032,China)

机构地区：[1]中国人民解放军空军军医大学西京医院心血管外科,西安710032

出　　处：《临床小儿外科杂志》2022年第11期1067-1074,共8页Journal of Clinical Pediatric Surgery

基　　金：国家重点研发计划(2016YFC1301901)

摘　　要：目的通过Meta分析探究新生儿先天性动脉导管未闭(patent ductus arteriosus,PDA)与新生儿母亲糖尿病(infants of diabetic mothers,IDM)的相关性,为新生儿PDA预防提供理论依据。方法计算机检索Web of Science、PubMed、Scopus、Embase、Cochrane、ProQuest、OVID、CNKI、WanFang、VIP、SinoMed数据库,检索词:动脉导管未闭、动脉导管开放、先天性动脉导管未闭、糖尿病、妊娠期糖尿病。检索时间为建库至2021年8月。由两位研究者独立筛检出符合纳入标准的文献,提取文献资料、评价文献质量。以医嘱诊断为准,将新生儿分为PDA组和非PDA组。按病例所在区域、研究设计、糖尿病类型进行亚组分析。采用Stata 14.0进行统计分析。结果最终纳入Meta分析的文献共11篇(样本总数为1014399例)。Meta分析显示,新生儿PDA组IDM患病率是新生儿非PDA组的1.25倍,差异无统计学意义[RR=1.25,95%CI:(0.97~1.61),P=0.086]。按病例所在区域分组的亚组分析结果显示,亚洲组新生儿PDA的发生与是否存在IDM无关[RR=1.05,95%CI:(0.92~1.21),P=0.471],欧洲组新生儿PDA患儿母亲IDM的患病率是新生儿非PDA组的2.45倍,差异有统计学意义[RR=2.45,95%CI:(1.98~3.02),P<0.001];队列研究亚组与病例对照研究亚组、妊娠期糖尿病(gestational diabetes mellitus,GDM)亚组与孕前糖尿病(pregestational diabetes mellitus,PGDM)亚组相比较,均提示新生儿PDA的发生与是否存在IDM无关。敏感性分析显示研究结果稳定可靠,无显著发表偏倚。结论新生儿PDA的发生与是否存在IDM无关。Objective To explore the correlation between neonatal patent ductus arteriosus(PDA)and infants of diabetic mothers(IDM)through a Meta-analysis to provide theoretical rationales for preventing neonatal PDA.Methods The databases of Web of Science,PubMed,Scopus,Embase,Cochrane,ProQuest,OVID,CNKI,WanFang,VIP and SinoMed were searched from the inceptions to August 2021.The search terms included patent ductus arteriosus,ductus arteriosus,patent of arterious ductus,diabetes,diabetes mellitus,hyperglycemia,maternal hyperglycemia and maternal diabetes mellitus.Two independent researchers conducted literature screening,data extracting and quality evaluations.The neonates were assigned into two groups of PDA and no-PDA according to the diagnosis.Subgroup analysis was conducted according to case locality,study design and type of diabetes.And Stata 14.0 was utilized for statistical prcoessing.Results Eleven studies with a total of 1014399 samples were included.Meta-analysis indicated that the prevalence of IDM was 1.25 folds higher in neonatal PDA group than that in neonatal non-PDA group.The difference was not statistically significant(RR=1.25,95%CI:0.97-1.61,P=0.086).Subgroup analysis revealed no significant difference in neonatal PDA or IDM in Asian subgroups(RR=1.05,95%CI:0.92-1.21,P=0.471)and the prevalence of IDM was 2.45 folds in neonatal PDA group than that in neonatal no-PDA group(RR=2.45,95%CI:1.98-3.02,P<0.001).Comparing cohort study,case-control study,gestational diabetes mellitus(GDM)and pregestational diabetes mellitus(PGDM)subgroups revealed no significant difference in neonatal PDA or IDM.The sensitivity of each study was robust and publication bias stable.Conclusion No statistically significant correlation exists between IDM and neonatal PDA in overall studies.

关 键 词：婴儿 新生 动脉导管未闭 母亲营养生理学现象 糖尿病 妊娠 

分 类 号：R72[医药卫生—儿科]