妊娠期钙补充预防先兆子痫的Meta分析  

Calcium supplement in pregnancy for prevention of preeclampsia: a meta-analysis

作　　者：李慧娟 姚亮[5,6] 闫沛静 李美萱[1,2,3,4] 荀杨芹 卢存存 杨克虎 张登霞 LI Huijuan;YAO Liang;YAN Peijing;LI Meixuan;XUN Yangqin;LU Cuncun;YANG Kehu;ZHANG Dengxia(School of Public Health,Lanzhou University,Lanzhou,730000,P.R.China;Evidence-based Medicine Center,School of Basic Medical Sciences,Lanzhou University,Lanzhou,730000,P.R.China;Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province,Lanzhou,730000,P.R.China;Evidence-based Social Sciences Research Center,Lanzhou University,Lanzhou,730000,P.R.China;Chinese Medicine Faculty of Hongkong Baptist University,HongKong,999077,P.R.China;Institution of Clinical Research and Evidence Based Medicine,The Gansu Provincial Hospital,Lanzhou,730000,P.R.China;Gansu Provincial Hospital,Lanzhou,730000,P.R.China;The Second Changzhou Hospital,Nanjing Medical University,Changzhou,213003,P.R.China)

机构地区：[1]兰州大学公共卫生学院,兰州730000 [2]兰州大学循证医学中心/兰州大学基础医学院,兰州730000 [3]甘肃省循证医学与临床转化重点实验室,兰州730000 [4]兰州大学循证社会科学研究中心,兰州730000 [5]香港浸会大学中医药学院,香港999077 [6]甘肃省人民医院临床循证医学研究所,兰州730000 [7]甘肃省人民医院,兰州730000 [8]南京医科大学附属常州第二人民医院,江苏常州213003

出　　处：《中国循证医学杂志》2018年第10期1070-1079,共10页Chinese Journal of Evidence-based Medicine

摘　　要：目的探讨妊娠期钙补充对先兆子痫(preeclampsia,PE)发生及相关母婴结局的影响。方法计算机检索The Cochrane Library、PubMed、EMbase、CBM、WanFang Data、VIP和CNKI数据库,搜集钙补充干预先兆子痫及相关母婴结局的随机对照试验(RCT),检索时限均从建库至2018年7月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevM an 5.3软件进行Meta分析。结果共纳入33个RCT,包括29 234例研究对象。Meta分析结果显示:与对照组相比,钙补充可有效预防先兆子痫[RR=0.48,95%CI(0.38,0.62),P<0.000 01]和妊娠型高血压的发生[RR=0.65,95%CI(0.55,0.77),P<0.000 01]。钙补充组的早产、宫内发育迟缓和严重先兆子痫发生率均低于安慰剂组;钙补充组新生儿体重高于安慰剂组。但两组妊娠周期的差异无统计学意义(P>0.005)。结论当前证据显示,钙补充能够预防先兆子痫及相关不良结局,改善母婴健康。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。Objectives To investigate calcium supplement in pregnancy for prevention of preeclampsia and relevant outcomes. Methods The Cochrane Library, PubMed, EMbase, CBM, WanFang Data, VIP and CNKI databases were searched online to collect randomized controlled trials（RCTs） of calcium supplement in pregnancy for prevention of preeclampsia and relevant outcomes from inception to July 2018. Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software.Results A total of 33 RCTs involving 29 234 subjects were included. The results of meta-analysis showed that： compared with control group, the calcium supplement group was associated with lower preeclampsia（RR=0.48, 95%CI 0.38 to 0.62,P 〈0.000 01） and gestational hypertension（RR=0.65, 95%CI 0.55 to 0.77, P〈0.000 01） incidence. The incidence of premature delivery, intrauterine growth retardation and severe preeclampsia in calcium supplement group was lower than that in placebo group, and the neonatal weight in calcium was higher than that in placebo group. However, there was no significant difference in the pregnancy cycle between the two groups. Conclusions Current evidence shows that calcium supplement is associated with lower risk of preeclampsia and gestational hypertension. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.

关 键 词：先兆子痫 钙补充 妊娠高血压 钙剂量 META分析 系统评价 随机对照试验 

分 类 号：R714.244[医药卫生—妇产科学]