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泼尼松龙给药对不明原因复发性流产患者及常规卵胞浆内单精子注射的影响:一项荟萃分析。

Effect of Prednisolone Administration on Patients with Unexplained Recurrent Miscarriage and in Routine Intracytoplasmic Sperm Injection: A Meta-Analysis.

作者信息

Dan Song, Wei Wang, Yichao Shi, Hongbo Cheng, Shenmin Yang, Jiaxiong Wang, Hong Li

机构信息

Center for Reproduction and Genetics, Suzhou Municipal Hospital, Affiliated Hospital of Nanjing Medical University, Suzhou, China.

出版信息

Am J Reprod Immunol. 2015 Jul;74(1):89-97. doi: 10.1111/aji.12373. Epub 2015 Mar 5.

Abstract

The effects of prednisolone on pregnancy outcome are open to debate. This meta-analysis was performed to evaluate the efficiency of prednisolone administration on unexplained recurrent miscarriage (RM) and the process of assisted reproductive technology (ART). Relevant publications were searched from databases and the included randomized controlled trials (RCTs) investigated effects of prednisolone administration in women with unexplained RM or during ART. The outcomes in our analysis were measured in terms of risk ratios (RRs) with 95% confidence intervals (CI) using random effect models. This meta-analysis was performed based on pregnancy outcomes following prednisolone treatment. This meta-analysis provides evidence that prednisolone therapy improves pregnancy outcomes in women with idiopathic RM (live birth rate: RR 1.58, 95% CI 1.23-2.02; successful pregnancy outcome: RR 7.63, 95% CI 3.71-15.69; miscarriage rate: RR 0.42, 95% CI 0.28-0.61). Our meta-analysis revealed a non-significant effect of prednisolone on pregnancy outcome during intracytoplasmic sperm injection (ICSI) cycles (pregnancy rate: RR 1.02, 95% CI 0.84-1.24; clinical pregnancy rate: RR 1.01, 95% CI 0.82-1.24; implantation rate: RR 1.04, 95% CI 0.85-1.28). Prednisolone administration may improve pregnancy outcomes in women with idiopathic RM; its efficacy in women undergoing ICSI is not significant.

摘要

泼尼松龙对妊娠结局的影响尚无定论。本荟萃分析旨在评估泼尼松龙治疗不明原因复发性流产(RM)及辅助生殖技术(ART)过程中的疗效。从数据库中检索相关出版物,纳入的随机对照试验(RCT)研究了泼尼松龙对不明原因RM女性或ART期间女性的影响。我们分析中的结局指标采用随机效应模型,以风险比(RR)及95%置信区间(CI)衡量。本荟萃分析基于泼尼松龙治疗后的妊娠结局进行。本荟萃分析提供的证据表明,泼尼松龙治疗可改善特发性RM女性的妊娠结局(活产率:RR 1.58,95%CI 1.23 - 2.02;成功妊娠结局:RR 7.63,95%CI 3.71 - 15.69;流产率:RR 0.42,95%CI 0.28 - 0.61)。我们的荟萃分析显示,泼尼松龙对卵胞浆内单精子注射(ICSI)周期的妊娠结局无显著影响(妊娠率:RR 1.02,95%CI 0.84 - 1.24;临床妊娠率:RR 1.01,95%CI 0.82 - 1.24;着床率:RR 1.04,95%CI 0.85 - 1.28)。泼尼松龙治疗可能改善特发性RM女性的妊娠结局;其对接受ICSI治疗女性的疗效不显著。

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