早产与儿童急性白血病发生风险的Meta分析  

Preterm birth and subsequent risk of acute childhood leukemia: a meta-analysis

作　　者：黄艳 马倩倩[2] 黄启涛[3] 钟梅[3] 周琳[2] 佘秋敏 胡佳[2] 梁小珍[2] 

机构地区：[1]深圳市宝安区计划生育专科医院,518101 [2]南方医科大学第一临床医学院 [3]南方医科大学南方医院妇产科

出　　处：《妇产与遗传（电子版）》2016年第2期35-44,共10页Obstetrics-Gynecology and Genetics (Electronic Edition)

摘　　要：目的探讨早产与儿童急性白血病(acute leukemia,AL)发生风险的相关性。方法计算机检索Pub Med、Web of Science、Embase三大电子数据库从建库至2015年12月的所有文献,查找有关早产和儿童急性白血病发生风险的相关研究报告。纳入有关儿童急性白血病的随机对照研究和队列研究,由两名研究者独立对纳入实验进行质量评价和资料提取,并采用Rev Man 5.3软件和Stata 10.0进行Meta分析。结果最终共纳入12篇文献,其中8篇报道了急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL),7篇报道了急性髓系白血病(acute myeloid leukemia,AML)。共包括2786 687例儿童,其中急性白血病儿童13 319例。Meta分析表明,与正常儿童相比,早产儿童发生急性白血病的风险增加(OR=1.09,95%CI=1.02-1.17,P=0.01)。其中AML发生风险显著增加(OR=1.42,95%CI=1.21-1.67,P<0.01),ALL发生风险与正常儿童相比无显著差异(OR=1.04,95%CI=0.96-1.13,P=0.29)。漏斗图的对称性较好,不存在发表偏倚。结论早产是儿童急性白血病发生的危险因素之一。Objective To evaluate the relationship between preterm birth and risk of acute childhood leukemia. Methods Literature search was done in three electronic databases （ PubMed、 Web of Science、Embase） since established to December 31st, 2015. Relevant studies reporting the association between preterm birth and subsequent risk of acute childhood leukemia were included and for further evaluation. Two independent investigators performed the data extraction. Statistical analysis was performed using Revmen 5. 3 and Stata 10. 0. Results A total of 12 studies for acute childhood leukemia, eight studies for acute lymphoblastic leukemia （ ALL） and seven studies for acute myeloid leukemia （ AML） were included in the current meta-analyses. 13, 319 cases of acute childhood leukemia occurred among 2786,687 children. Our results suggested that preterm birth was significantly associated with increased risk of acute childhood leukemia （ OR = 1. 09, 95% CI= 1. 02 - 1. 17, P = 0. 01） and AML （OR= 1. 42,95% CI = 1. 21 - 1. 67,P 〈 0.01 ） . And preterm birth was not significantly associated with increased risk of ALL （ OR = 1. 04, 95% CI= 0. 96 - 1. 13, P =0. 29） . The funnel plots presented symmetrical graphics, indicating that there was no publication bias. Conlusions Preterm birth is a risk factor of acute childhood leukemia.

关 键 词：早产 儿童 白血病 META分析 

分 类 号：R733.71[医药卫生—肿瘤] R722.6[医药卫生—临床医学]