初产妇子痫前期发病风险与前次妊娠早孕期经过相关性的Meta分析  

A Meta-analysis of the correlation between the risk of preeclampsia in primipara and the first trimester of previous pregnancy

作　　者：贾柠伊 李坚[2] 马雪莲[1] 韩丹[1] 冯力民[1] Jia Ningyi;Li Jian;Ma Xuelian;Han Dan;Feng Limin(Department of Obstetrics&Gynecology y Beijing Tiantan Hospital,Capital Medical University y Beijing 100070;Department of Family Planning,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006,P.R.China)

机构地区：[1]首都医科大学附属北京天坛医院妇产科,北京100070 [2]首都医科大学附属北京妇产医院计划生育科,北京100006

出　　处：《中国计划生育和妇产科》2022年第3期39-43,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的 荟萃分析研究前次妊娠早孕期经过对于初产妇子痫前期(Preeclampsia, PE)发病风险的影响。方法 通过检索Pubmed、Cochrane Library以及Embase数据库2021年前的相关研究,纳入涉及前次早期妊娠经过与PE发病风险的相关文献,从中筛选出11篇文献进行Meta分析。用固定效应模型分析PE发病风险,采用Begg’s检验和Egger检验分析发表偏倚。统计学软件采用STATA 15.0。结果 共11篇文献纳入Meta分析,均为回顾性研究即病例对照研究。结果显示,对于初产妇而言,前次正常妊娠早孕期经过可能降低PE的发病风险[比值比(odd ratio,OR)=0.86,95%置信区间(confidence interval,CI)=0.81-0.91,I^(2)=47.4%],而既往自然流产史对于PE发病无保护作用(OR=1.00,95%CI=0.95-1.06,I^(2)=29%)。无明显发表偏倚。结论 前次妊娠早孕期正常经过或可降低PE发病风险,即妊娠早期可能已经产生“记忆”,对未来的妊娠起到保护作用。Objective A Meta-analysis examining the effect of first trimester passage on the risk of preeclampsia(PE) in primipara.Methods By searching Pubmed, Cochrane Library and Embase database for relevant studies before 2021, the literatures related to the risk of PE and the previous first trimester pregnancy were included, and 11 literatures were screened for Meta-analysis.A fixed-effects model was used to analyze the risk of PE, and Begg’s test and Egger’s test were used to analyze publication bias.The statistical software used STATA 15.0.Results A total of 11 literatures were included in the Meta-analysis, all of which were retrospective studies, namely case-control studies.The results showed that for primiparous women, the first trimester of previous normal pregnancy may reduce the risk of PE [odd ratio(OR)=0.86,95% confidence interval(CI)=0.81-0.91,I^(2)=47.4%],while a history of spontaneous abortion was not protective against PE(OR=1.00,95% CI=0.95-1.06,I^(2)=29%).No apparent publication bias.Conclusion The normal passage of the previous pregnancy in the first trimester may reduce the risk of PE, that is, "memory" may have been generated in the early pregnancy, which plays a protective role in future pregnancies.

关 键 词：人工流产 自然流产 子痫前期 META分析 

分 类 号：R714.244[医药卫生—妇产科学]