孕妇人型支原体感染与不良妊娠结局关联的Meta分析  

Association between Mh Infection Andadverse Pregnancy Outcome:A Meta-Analysis

作　　者：徐敏[1] 于红[2] 周瑾[1] 王蓓[1] 

机构地区：[1]东南大学公共卫生学院流行病与卫生统计学系,南京210009 [2]东南大学附属中大医院妇产科,南京210009

出　　处：《循证医学》2016年第2期86-92,共7页The Journal of Evidence-Based Medicine

基　　金：国家自然科学基金资助项目(30872156);教育部博士点基金资助项目(20130092110048)

摘　　要：目的探讨孕妇人型支原体感染与不良妊娠结局的关系。方法以人型支原体和不良妊娠结局（包括早产、胎膜早破、自然流产、低出生体重等）为检索词,系统检索Pub Med、Web of Science、EMBASE、中国知网、维普和万方数据库,收集公开发表的有关人型支原体感染与不良妊娠结局关系的研究文献。采用Stata 12.0软件进行Meta分析,用NOS质量评价量表对文献质量进行评估。采用漏斗图、Begg检验及Egger检验评估发表偏倚,并计算失安全系数以评价Meta分析结果的可靠性。结果共纳入32篇文献,累计病例3 236例,对照组4 310例。孕妇人型支原体感染与不良妊娠结局的合并比值比=3.13（95%可信区间2.64~3.70）,其中人型支原体感染与早产的合并比值比=3.43（95%可信区间2.17~5.44）,人型支原体感染与胎膜早破的合并比值比=2.56（95%可信区间1.33~4.90）,人型支原体感染与自然流产的合并比值比=3.38（95%可信区间2.62~4.35）。针对不同的研究类型,病例对照研究中人型支原体感染与不良妊娠结局的合并比值比=2.98（95%可信区间2.46~3.60）,队列研究中人型支原体感染与不良妊娠结局的相对危险度=2.88（95%可信区间2.16~3.83）。针对不同的人群,中国人群中人型支原体感染与不良妊娠结局的合并比值比=3.32（95%可信区间2.75~4.01）,非中国人群中的合并比值比=2.41（95%可信区间1.65~3.52）。漏斗图基本对称,Begg检验及Egger检验P值分别为0.05和0.13,失安全系数Nfs=1 825。结论孕妇人型支原体感染与不良妊娠结局有关。Objective To explore the association between Mh infection and adverse pregnancy outcomes.Methods Some electronic databases including Pub Med,Web of Science,EMBASE,CNKI,VIP,and Wanfang database were researched for mycoplasma and adverse pregnancy outcomes,including premature delivery,premature rupture of membranes,spontaneous abortion or low birth weight. Stata 12.0 software was used for the meta analysis.The NOS scale was used to evaluate the quality of the literature. Publication bias was evaluated by funnel figure,Begg Egger,and the fail- safe number was calculated to estimate the reliability of the meta analysis. Results 32 articles were included,the numbers of cases and controls were 3 236 and 4 310,respectively. The pooled OR value（pooled OR＇s95%CI）of Mh infection in pregnant women and adverse pregnancy outcomes was 3.13（95%CI 2.64~3.70）. And the differences among Mh infectionand different pregnancy outcomes were statistically significant,premature delivery：OR=3.43（95%CI 2.17~5.44）;premature rupture of membranes：OR=2.56（95%CI 1.33~4.90）;spontaneous abortion：OR=3.38（95%CI 2.62~4.35）;the differences between Mh infection and adverse pregnancy outcomeswere also statistically significant in different research types [case control study：OR=2.98（95%CI 2.46~3.60;cohort study：RR=2.88（95%CI2.16~3.83）]. About regions,Chinese people：OR=3.32（95%CI 2.75~4.01）;non-Chinese people：OR=2.41（95%CI1.65~3.52）. The funnel figure was fundamental symmetric. P values of Begg and Egger test were 0.05 and 0.13 respectively,the fail-safe number was 1 825. Conclusion Mh infection among pregnant women might contribute to adverse pregnancy outcomes.

关 键 词：人型支原体(Mh) 妊娠结局 META分析 

分 类 号：R446.5[医药卫生—诊断学] R714.251[医药卫生—临床医学]