Huang Q T, Chen J H, Zhong M, Xu Y Y, Cai C X, Wei S S, Hang L L, Liu Q, Yu Y H
Division of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto M5T 3H7, Canada.
Division of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China.
Placenta. 2014 Aug;35(8):539-45. doi: 10.1016/j.placenta.2014.05.007. Epub 2014 Jun 5.
Several epidemiological studies have found a positive association between chronic hepatitis B virus (CHB) infection and the risk of placental abruption and placenta previa, but various studies have reported conflicting findings. The objective was to systematically review the literature to determine a possible association between CHB infection and these two placental complications.
We conducted a computerized search in electronic database through March 1, 2014, supplemented with a manual search of reference lists, to identify original published research on placental abruption and placenta previa rates in women with CHB infection. Data were independently extracted, and relative risks were calculated. The meta-analysis was performed using Stata version 10.0 software.
Five studies involving 9088 placenta previa cases were identified. No significant association between CHB infection and placenta previa was identified (OR = 0.98, 95% CI = 0.60-1.62). Five studies involving 15571 placental abruption cases were identified. No significant association between CHB infection and placental abruption was identified (OR = 1.42, 95% CI, 0.93-2.15).
The immune response against the virus represents a key factor in determining infection outcomes. No observation of significant increased risk of the placental complications could be partially explained by the complex immune response during CHB infection.
Our meta-analysis found no evidence of significant associations between CHB infection and increased risk of placental abruption as well as placenta previa. Further well-designed studies were warranted to assess any potential association between CHB infection and increased risk of placental abruption as well as placenta previa.
多项流行病学研究发现，慢性乙型肝炎病毒（CHB）感染与胎盘早剥和前置胎盘风险之间存在正相关，但不同研究报告的结果相互矛盾。目的是系统回顾文献，以确定CHB感染与这两种胎盘并发症之间可能存在的关联。
我们在电子数据库中进行了计算机检索，截至2014年3月1日，并辅以手动检索参考文献列表，以识别关于CHB感染女性胎盘早剥和前置胎盘发生率的原始发表研究。数据被独立提取，并计算相对风险。使用Stata 10.0软件进行荟萃分析。
确定了五项涉及9088例前置胎盘病例的研究。未发现CHB感染与前置胎盘之间存在显著关联（OR = 0.98，95% CI = 0.60 - 1.62）。确定了五项涉及15571例胎盘早剥病例的研究。未发现CHB感染与胎盘早剥之间存在显著关联（OR = 1.42，95% CI，0.93 - 2.15）。
针对病毒的免疫反应是决定感染结果的关键因素。未观察到胎盘并发症风险显著增加，这可能部分归因于CHB感染期间复杂的免疫反应。
我们的荟萃分析未发现CHB感染与胎盘早剥和前置胎盘风险增加之间存在显著关联的证据。需要进一步设计良好的研究来评估CHB感染与胎盘早剥和前置胎盘风险增加之间的任何潜在关联。
