Conde-Agudelo A, Althabe F, Belizán J M, Kafury-Goeta A C
Latin American Center for Perinatology and Human Development, Pan American Health Organization, World Health Organization, Montevideo, Uruguay.
Am J Obstet Gynecol. 1999 Oct;181(4):1026-35. doi: 10.1016/s0002-9378(99)70341-8.
In this systematic review of the existing evidence regarding the relationship between cigarette smoking during pregnancy and preeclampsia, studies were found through searches of MEDLINE (1966-October 31, 1998), Embase, Popline, CINAHL, Lilacs, bibliographies of identified studies, and proceedings of meetings on preeclampsia, and also through contact with relevant researchers. No language restrictions were imposed. Only cohort and case-control studies dealing with the relationship between cigarette smoking and preeclampsia were considered. Assessment of methodologic quality and data extraction of each study were carried out by 2 authors working independently. Typical relative risks and odds ratios with 95% confidence intervals were calculated for cohort and case-control studies, respectively, with both fixed and random effects models. Twenty-eight cohort studies and 7 case-control studies including a total of 833,714 women were included. All cohort studies reported an inverse association between cigarette smoking during pregnancy and incidence of preeclampsia (typical relative risk, 0.68; 95% confidence interval, 0.67-0.69). The findings were similar for case-control studies (typical odds ratio, 0.68; 95% confidence interval, 0.57-0.81). An inverse dose-response relationship was also found. Pooled data from cohort and case-control studies showed a lower risk of preeclampsia associated with cigarette smoking during pregnancy.
在本次对现有关于孕期吸烟与先兆子痫之间关系的证据的系统评价中，通过检索MEDLINE（1966年至1998年10月31日）、Embase、Popline、CINAHL、Lilacs、已识别研究的参考文献以及先兆子痫会议记录，并通过与相关研究人员联系来查找研究。未设语言限制。仅纳入了涉及吸烟与先兆子痫之间关系的队列研究和病例对照研究。由两名独立工作的作者对每项研究进行方法学质量评估和数据提取。分别使用固定效应模型和随机效应模型，为队列研究和病例对照研究计算了典型相对风险和比值比以及95%置信区间。共纳入了28项队列研究和7项病例对照研究，涉及833,714名女性。所有队列研究均报告孕期吸烟与先兆子痫发病率呈负相关（典型相对风险为0.68；95%置信区间为0.67 - 0.69）。病例对照研究的结果相似（典型比值比为0.68；95%置信区间为0.57 - 0.81）。还发现了负剂量反应关系。队列研究和病例对照研究的汇总数据显示，孕期吸烟与先兆子痫风险较低相关。
