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绒毛取样对先兆子痫和妊娠期高血压发生的影响:一项更新的系统评价和荟萃分析。

Effect of chorionic villus sampling on the occurrence of preeclampsia and gestational hypertension: An updated systematic review and meta-analysis.

作者信息

Başaran Ahmet, Başaran Mustafa, Topatan Betül, Martin James N

机构信息

Department of Obstetrics and Gynecology, Konya Training and Research Hospital, Konya, Turkey.

Department of Anesthesiology, Konya Training and Research Hospital, Konya, Turkey.

出版信息

J Turk Ger Gynecol Assoc. 2016 Jan 12;17(2):65-72. doi: 10.5152/jtgga.2016.16026. eCollection 2016.

Abstract

OBJECTIVE

To perform a meta-analysis for an assessment of the risk of preeclampsia or gestational hypertension following chorionic villus sampling (CVS).

DATA SOURCE

PubMed was systematically searched from its inception through January 2016.

MATERIAL AND METHODS

Nine reports were identified. A pre-specified scale was used to assess their quality.

TABULATION INTEGRATION AND RESULTS

We performed pooling into three subgroups with respect to the control group: A) Patients with no invasive prenatal diagnostic procedure served as a control group for comparison. The odds ratios for gestational hypertension (0.76, 95% CI 0.46-1.26), preeclampsia (0.83, 95% CI 0.42-1.67), and severe preeclampsia (0.49, 95% CI 0.04-5.78) or when hypertension categories were pooled (0.80, 95% CI 0.46-1.41) were not significantly different. B) Patients with midtrimester diagnostic amniocentesis and patients with no invasive prenatal diagnostic procedure were combined as a control group for comparison. The odds ratios for preeclampsia (1, 95% CI 0.46-2.18), severe preeclampsia (0.83, 95% CI 0.14-4.85), and pooled hypertension categories (1.07, 95% CI 0.63-1.84) were not significantly different. C) Patients with midtrimester diagnostic amniocentesis served as a control group. There was a significant difference in the odds ratio for preeclampsia between the CVS and amniocentesis groups (2.47, 95% CI 1.14-5.33). There was a marginal difference in the odds ratio for combined pregnancy-induced hypertension categories between the CVS and amniocentesis groups (1.61, 95% CI 1.02-2.53).

CONCLUSION

The available data do not indicate an increased risk of preeclampsia or gestational hypertension following first trimester CVS. The heterogeneity and retrospective design of existing studies are limiting factors for our analysis and findings.

摘要

目的

进行一项荟萃分析,以评估绒毛取样(CVS)后发生子痫前期或妊娠期高血压的风险。

数据来源

对PubMed从创刊至2016年1月进行系统检索。

材料与方法

识别出9篇报告。使用预先指定的量表评估其质量。

表格整合与结果

我们根据对照组将其分为三个亚组:A)未进行侵入性产前诊断程序的患者作为对照组进行比较。妊娠期高血压的优势比(0.76,95%可信区间0.46 - 1.26)、子痫前期(0.83,95%可信区间0.42 - 1.67)、重度子痫前期(0.49,95%可信区间0.04 - 5.78)或合并高血压类别时(0.80,95%可信区间0.46 - 1.41)无显著差异。B)孕中期诊断性羊膜穿刺术患者与未进行侵入性产前诊断程序的患者合并作为对照组进行比较。子痫前期的优势比(1,95%可信区间0.46 - 2.18)、重度子痫前期(0.83,95%可信区间0.14 - 4.85)以及合并高血压类别(1.07,95%可信区间0.63 - 1.84)无显著差异。C)孕中期诊断性羊膜穿刺术患者作为对照组。CVS组与羊膜穿刺术组子痫前期的优势比有显著差异(2.47,95%可信区间1.14 - 5.33)。CVS组与羊膜穿刺术组合并妊娠高血压类别的优势比有边缘差异(1.61,95%可信区间1.02 - 2.53)。

结论

现有数据未表明孕早期CVS后子痫前期或妊娠期高血压风险增加。现有研究的异质性和回顾性设计是我们分析和研究结果的限制因素。

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